About chemotherapy for chronic lymphocytic leukaemia (CLL)

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

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.

The chemotherapy drugs most often used to treat chronic lymphocytic leukaemia (CLL) are:

Some of the possible chemotherapy and targeted therapy combinations include:

  • Fludarabine and cyclophosphamide are usually given together with a targeted therapy called rituximab. This combination is called FCR or RFC.
  • Chlorambucil chemotherapy is often given along with a targeted therapy.
  • Bendamustine 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 they think is best for your situation.

You can usually have chemotherapy for CLL as an outpatient.

We have more information about chemotherapy and treatment for CLL.

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 two 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. You can read more about side effects you may get from the specific drugs you are having.

You can talk to your doctor or nurse about what to expect from the treatment that is planned for you.

Irradiated blood

If you need a blood transfusion or a platelet transfusion and you have been treated with fludarabine or bendamustine, these transfusions should be treated with radiation (irradiated).

Irradiated transfusions should always be used during and after you have finished your treatment. This lowers the risk of the donated blood cells reacting against your own. Your hospital team should give you a card to carry or a MedicAlert ID tag to wear, so that the hospital staff are aware in case of an emergency.

We have more information about the side effects of chemotherapy.

About our information


  • 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 Helen Marr, 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.