Chemotherapy for chronic lymphocytic leukaemia (CLL)

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy or damage leukaemia cells. Chemotherapy for chronic lymphocytic leukaemia (CLL) is often given with targeted therapy.

What is chemotherapy?

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy or damage leukaemia cells. These drugs affect with the way leukaemia cells grow and divide.

About chemotherapy for chronic lymphocytic leukaemia (CLL)

You can have the chemotherapy drugs as tablets (oral chemotherapy) or into a vein (intravenously). The chemotherapy moves around the body through the blood. It can reach leukaemia cells all over the body.

You may have either a single chemotherapy drug or a combination of different drugs given together. Chemotherapy is usually given with a targeted therapy. This is called chemo-immunotherapy.

You usually have chemotherapy as several cycles of treatment. Each treatment is followed by a rest period. This lets your body recover from any side effects. The treatment and the rest period together make up a cycle of treatment.

The chemotherapy drugs most often used to treat CLL are:

Fludarabine and cyclophosphamide are usually given together with a targeted therapy called rituximab. This combination is called FCR or RFC. The chemotherapy drugs can be given into a vein or as tablets.

Chlorambucil is given as tablets. It is often given along with a targeted therapy.

Bendamustine is given into a vein. It is usually given with rituximab. This treatment is called BR.

There are lots of different drugs available to treat CLL. Your doctors may use other drugs and combinations of drugs. They will tell you what treatment option they think is best for your situation.

You can usually have chemotherapy for CLL as an outpatient.

Side effects of chemotherapy for chronic lymphocytic leukaemia (CLL)

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 2 or more chemotherapy drugs may cause more side effects.

Side effects can include:

We have listed some of the most common side effects of chemotherapy. Different chemotherapy drugs have different side effects. We have more information on side effects of other drugs in our A-Z of treatment.

You can talk to your doctor or nurse about what to expect from the treatment that is planned for you. We have more information about the side effects of chemotherapy.

About our information


  • References

    Below is a sample of the sources used in our chronic lymphocytic leukaemia (CLL) information. If you would like more information about the sources we use, please contact us at

    Schuh A et al. Guideline for the treatment of chronic lymphocytic leukaemia. British Society for Haematology Guidelines. July 2018.

    Eichhorst B et al. Chronic lymphocytic leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. ESMO Guidelines Committee. October 2020.


  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

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Date reviewed

Reviewed: 01 January 2022
Next review: 01 January 2025
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.