Treatment for chronic lymphocytic leukaemia (CLL)
Chronic lymphocytic leukaemia (CLL) usually develops very slowly, so you may not need treatment for months or years. Some people will never need treatment.
About chronic lymphocytic leukaemia (CLL) treatment
Chronic lymphocytic leukaemia (CLL) and small lymphocytic lymphoma (SLL) are treated as different forms of the same blood cancer. In this information, we use the term CLL to refer to both types.
CLL usually develops very slowly. You may not need to start treatment for months or years. Some people never need treatment.
Even if you are not having any treatment, you will be in contact with your cancer team for regular check-ups and blood tests. This is called active monitoring (watch and wait).
Doctors usually wait until there are signs that CLL is causing symptoms before suggesting you have treatment. There is no evidence that starting treatment before this helps. Treatment can also cause side effects.
Deciding when to start treatment for CLL
Only a small number of people with CLL need to start treatment straight away. Your cancer team will decide whether you need treatment.
The treatment you have depends on:
- the stage of CLL
- the signs and symptoms you have
- results from genetic tests
- your general health
- your preferences.
Types of treatment for CLL
Treatment for CLL usually involves targeted therapies. These can be given on their own or in combination with other types of targeted therapy such as monoclonal antibodies.
Very rarely, other cancer treatments used to treat CLL include:
- chemoimmunotherapy
- donor (allogeneic) stem cell transplant
- radiotherapy
- surgery to remove the spleen.
You may also have supportive treatments. These are treatments that help prevent or control any symptoms caused by CLL or its treatment.
There are many new treatments being developed to improve the outcomes for people with CLL. You may be invited to take part in a clinical trial. Ask your doctor about any clinical trials that may be suitable for you.
Blood tests before treatment
Related pages
Treatment aim
The aim of treatment is to reduce symptoms and control the CLL for as long as possible, with the fewest side effects. It is not possible to cure CLL, but it can be well controlled.
Most people with CLL have long periods of time when they have a normal life with no symptoms. They may also have a normal life span.
Treating relapsed or refractory CLL
For most people, treatment is very successful. Some people may stay in remission for several years. Remission means there is no sign of active CLL in the body.
But it is common for CLL to come back (relapse) and need more treatment. Some people may need to be treated several times during their illness. When CLL does not respond to treatment, this is called refractory disease. It is usually treated in the same way as relapsed disease.
If you relapse, your haematologist will discuss your treatment plan with you. They will consider:
- how long you have been in remission
- the treatments you had before and how well they worked
- results from genetic tests
- your general health
- your preferences.
Treatments can include the following:
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Targeted therapy
You usually have targeted therapy drugs. You may have a different drug than you had before. Depending on your situation, you may be offered continuous treatment for as long as it works for you and you tolerate side effects. Or you may have treatment for a fixed period of time.
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Supportive treatments
You may also be offered supportive treatments to help prevent or control any symptoms caused by CLL.
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Other treatments
Very rarely, other cancer treatments used to treat relapsed CLL include chemoimmunotherapy, donor (allogeneic) stem cell transplant, or radiotherapy.
Treatment for transformed CLL
Transformed CLL often does not respond well to treatment. Many people with this condition are older and have usually had several treatments before.
Treatment can involve high dose chemotherapy followed by donor (allogeneic) stem cell transplant. This type of treatment is intensive, so you will need to be fit to tolerate it. Other treatments may be given as part of a clinical trial.
Getting support
We understand that having treatment can be a difficult time for people. We are here to support you. If you want to talk, you can:
- call the Macmillan Support Line for free on 0808 808 00 00
- chat to our cancer information specialists online
- visit our Online Community CLL, SLL, HCL forum to talk to people who have been affected by CLL, share your experience, and ask questions.
About our information
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.
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ReferencesBelow 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 cancerinformationteam@macmillan.org.uk
Eichhorst B, et al. Robak T, Montserrat E, et al. Chronic Lymphocytic Leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up. Annals of Oncology. Published online October 19 2020 32(1) 23-33. Available from: www.doi.org/10.1016/j.annonc.2020.09.019 [accessed 2023].
Walewska R, Eyre T.A, Bloor A et al. Guideline for the treament of chronic lymphocytic leukaemia. British Society for Haematology 2025. Br J Haematology Vol 207 (6) 2296-2313. Available from: www.doi.org/10.1111/bjh.70100 [accessed August 2026].
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