Treatment overview

Doctors will usually wait until you have symptoms before suggesting treatment. CLL usually develops very slowly, so people often don’t need treatment for months or years. Some people will never need it. However, people with symptoms caused by CLL may need treatment straight away. 

Even when you’re not having any treatment, you’ll still see your haematologist or GP regularly. This is usually called monitoring, or watch and wait.

Aims of treatment

Treatment aims to reduce the number of CLL cells to as few as possible, so you can have a normal life with no symptoms. This is called remission.

There are different levels of remission:

  • Complete remission (CR) – No CLL cells can be found.
  • Minimal residual disease (MRD) – There are so few CLL cells remaining that they can only be found with special blood tests.
  • Partial remission (PR) – The number of CLL cells in the blood and bone marrow has reduced and the lymph nodes are smaller, but CLL can still be found.

Treatment is very successful at getting the leukaemia into complete or partial remission in most people. This may last for years. If the leukaemia does start to grow again and begins to cause problems, you can have more treatment. This can be done several times.

If the leukaemia doesn’t respond well to the first treatment you have, your doctors can change the treatment.

If there’s no change after treatment, if the number of CLL cells increases, or if the lymph nodes get bigger, the CLL is described as refractory. This means the leukaemia cells haven’t responded to treatment.

If treatment to control CLL is no longer helpful, you can have supportive therapy with medicines and blood transfusions to reduce symptoms.

Starting treatment

There are a number of things your doctors will consider when deciding if you need treatment and which treatment might be best for you. These include checking for the following:

  • the number of white blood cells
  • very enlarged or fast-growing lymph nodes
  • low level of red blood cells (anaemia) or platelets
  • severe night sweats
  • weight loss.

Your doctor will also ask you about your general health and check your fitness when planning your treatment.

Back to Understanding your diagnosis

Staging

Staging describes how much leukaemia there is in your body. In the UK, the Binet system is used to stage CLL.

Treating CLL by stage

Stage A CLL often doesn’t need treatment. People with stage B or C CLL usually have chemotherapy and possibly targeted therapy.

My Cancer Treatment

Macmillan is supporting a new online tool to help you make decisions about your treatment and care. The tool currently only covers England.