Browser does not support script.
Skip to main content
search here
Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
Find out how we produce our information|
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy or damage leukaemia cells. The drugs can be given as tablets or into a vein (intravenously). The chemotherapy circulates in your blood and can reach leukaemia cells all over the body.
You may have either a single chemotherapy drug, or a combination of two or more different drugs given together. Chemotherapy for CLL can usually be given while you are an outpatient.
Before starting chemotherapy, you will have your height and weight checked. This is used to work out the right dose of chemotherapy for you. Chemotherapy is usually given as several sessions of treatment. Each treatment is followed by a rest period of a few weeks to allow your body to recover from any side effects. The treatment and the rest period together make up a cycle of treatment.
The drugs most often used to treat CLL are:
Chlorambucil chemotherapy is given as tablets. They can be prescribed in different ways, depending on your needs. They are usually taken for about seven days every four weeks.
Fludarabine and cyclophosphamide (FC) are usually given together. The treatment can be given as tablets or intravenously. It’s often given for five days every four weeks, but can be given in other ways. A monoclonal antibody called rituximab| may be given in combination with FC chemotherapy. This is called FC-R or R-FC treatment.
Fludarabine on its own isn’t given as a first treatment for CLL, but may be given to people who have previously had chlorambucil and who need further treatment when CLL returns. It’s most likely to be given to people who aren’t fit enough to cope with the possible side effects of two chemotherapy drugs combined.
Sometimes a combination of the chemotherapy drugs cyclophosphamide, vincristine| and doxorubicin| are given together. This is called CHOP chemotherapy|. It’s given intravenously, usually for one day every three weeks.
Steroid tablets| called prednisolone are taken for five days with each cycle of treatment.
Other drugs and combinations of drugs may be used. Your doctor will tell you what treatment they recommend for your situation.
We have sections discussing chemotherapy|, as well as on individual chemotherapy drugs| and combination regimens|, which you may find helpful.
If you are taking a single chemotherapy drug such as chlorambucil, any side effects you have will usually be mild. Treatment with a combination of two or more chemotherapy drugs may cause more troublesome side effects.
Chemotherapy destroys the leukaemia cells in your blood, but it also temporarily reduces the number of healthy white blood cells. Your blood cell levels will be checked regularly while you’re having treatment. If your white cell count is too low, you are more at risk of infection| and your treatment may be delayed for a while to allow it to recover.
While having chemotherapy, you should contact your doctor or the hospital straight away if you:
If you develop an infection, you may need to go into hospital for treatment. If the antibody levels in your blood are very low, you may be given antibodies (immunoglobulins) through an intravenous drip.
Your doctor may prescribe medicines to help prevent infection. If you are treated with fludarabine you may be given medicines to help prevent viral and fungal infections, while you are taking it. You may also need to take antibiotics for up to a year after fludarabine treatment to help prevent chest infections.
Chemotherapy can lower the number of red cells and platelets in the blood|:
If your red cells or platelets take a while to recover, you may need a blood| or platelet transfusion|. You can have transfusions as an outpatient.
If you’ve had treatment with the chemotherapy drugs fludarabine or cladribine, you should only be given blood that has been irradiated. This is to stop any white blood cells that may be in the blood transfusion from causing you problems.
Irradiating blood doesn’t make it radioactive. You will be given a card to carry to remind the hospital staff that you should only be given irradiated blood and it should be recorded in your hospital notes.
Some chemotherapy drugs can make you feel or be sick (nausea or vomiting|). Your doctor will prescribe anti-sickness (anti-emetic) drugs if the chemotherapy you’re being given could make you sick. There are several effective anti-sickness drugs so if you feel sick, let your doctor know.
Some chemotherapy drugs can make your mouth sore| and cause small ulcers. You may be given a mouthwash to use regularly. Your nurse will explain how to use it. If your mouth is sore it’s best to avoid alcohol and foods that are very hot, salty or highly spiced.
If you’re having treatment with two or more chemotherapy drugs or chemotherapy over a long period of time, you will probably feel more tired| than usual. If you feel tired, plan some rest periods into your day. Try to balance rest periods with some gentle activities when you feel able.
Not all chemotherapy drugs cause hair loss|. Whether you lose any hair during your treatment will depend on the treatment you have. Your doctor or chemotherapy nurse can tell you what to expect. Treatment with chlorambucil or FC chemotherapy doesn’t usually cause hair to fall out completely, although it may become thinner.
CHOP chemotherapy usually causes complete hair loss. This is temporary and your hair will start to grow back once you’ve finished treatment.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.