Chronic lymphocytic leukemia, or CLL, originates from white blood cells in the bone marrow, which then spread to the blood, according to the American Cancer Society. CLL usually grows slower than other forms of leukemia. Treatment for CLL typically depends on the stage of the cancer and how aggressive the cancer seems to be. Other factors that affect treatment decisions include the individual's overall health and whether symptoms are present.
Monoclonal Antibodies
Monoclonal antibodies are drugs that are developed in a laboratory that mimic proteins in the immune system that target certain components of cells, according to the National Cancer Institute. These may also be referred to as targeted therapies. These drugs can attack the cell at the target and aid the immune system in subsequently killing them. Monoclonal antibodies for CLL are given intravenously and can include the drugs rituximab, or Rituxan; alemtuzumab, or Campath; and ofatumumab, or Arzerra. The specific regimen may vary, depending on the drug being given and reactions to the medication. Side effects can include nausea, fever, chills, rashes, a lowered white cell count, which can lead to increased risk of infection, and blood pressure changes. These effects are temporary, and usually subside once treatment is over.
Chemotherapy
Chemotherapy uses anti-cancer drugs to kill cancer cells. These medications may be taken orally as a pill, given intravenously or injected into the cerebrospinal fluid. When given orally or intravenously, these medications are able to kill cancer cells throughout the body because they travel through the bloodstream. The American Cancer Society lists two classes of drugs that are used to treat CLL: purine analogs, including the medications fludarabine, pentostatin and cladribine; and alkylating agents like chlorambucil and cyclophosphamide. A new drug called bendamustine works like both classes of drugs. Side effects of chemotherapy can include hair loss, fatigue, lowered white and red blood cell counts that can lead to anemia and higher infection risk, nausea and vomiting, and mouth sores. Not everyone will have all of the side effects, and they typically resolve once chemotherapy has ended.
Radiation Therapy
Radiation therapy uses high energy rays to kill cancer cells and slow down the spread of the cancer. According to the American Cancer Society, radiation is not typically a main treatment for individuals with CLL, but may be used in conjunction with other treatments or in certain situations. Radiation can be used to ease symptoms if organs are enlarged from the leukemia and are causing difficulty breathing or pain in the bones, and for CLL, the treatment is often given externally, by a machine outside the body aiming the rays at the affected area.
Watchful Waiting
The National Cancer Institute lists watchful waiting as an option for people with CLL. In watchful waiting, the patient is closely monitored by an oncologist and treatment is postponed until symptoms appear or changes in health occur. Disease-related problems like infection are treated, but active treatment for the leukemia is not given.
