Lymphocytic leukemia, usually known by its full name of chronic lymphocytic leukemia, or CLL, is a form of cancer that affects white blood cells called lymphocytes. In CLL, there are too many lymphocytes circulating in the blood that are not fully developed and do not work effectively. These malfunctioning cells eventually replace healthy white and red blood cells, as well as platelets found in the bone marrow. According to Macmillan Cancer Research, CLL mainly affects people over age 60 and is more common in men than women. CLL often proceeds very slowly and people with the condition do not always require immediate treatment, says MayoClinic.com. However, intermediate or advanced stage CLL usually requires treatment.
Chemotherapy
The aim of chemotherapy is to put the cancer into remission. CancerHelp UK says that a typical combination of chemotherapeutic drugs is fludarabine and cyclophosphamide. This combination treatment is taken orally or through a drip. Since it can have unpleasant side effects, including cystitis, hair loss and nausea, a different drug known as chlorambucil may be prescribed for older and frail people. An alternative combination therapy comprises four drugs, cyclophosphamide, doxorubicin, vincristine and prednisone. This combination therapy is commonly known as CHOP. However, because CHOP often causes severe sickness, it is not usually the chemotherapeutic treatment of choice.
Biological Therapy
Biological therapy is another approach to CLL treatment and is helpful for people who develop resistance to chemotherapy. This type of therapy utilizes substances that naturally occur in the body or change the way substances in the body work. Two examples of biological therapies include the drugs alemtuzumab and rituximab. Alemtuzumab works by locating and attaching to cancerous lymphocytes, which it then destroys, and is administered either by an intravenous drip or by subcutaneous injection. Rituximab works by locating a protein known as CD20, which is found on both normal and leukemic lymphocytes. Rituximab sticks to the lymphocytes, which are then destroyed by the immune system. Healthy lymphocytes subsequently replace those that have been destroyed. Both alemtuzumab and rituximab have side effects, according to CancerHelp UK. These may include nausea, headache and fever. In addition, alemtuzumab may lower resistance to infection, and a doctor will usually prescribe antibiotics to use alongside alemtuzumab.
Bone Marrow Transplant
According to CancerHelp UK, a bone marrow stem cell transplant can be used to treat chronic lymphocytic leukemia. However, this kind of treatment is experimental and usually only carried out as part of a clinical trial. The procedure involves destroying a patient's bone marrow cells with high-dose chemotherapy. This has the effect of killing off not only the bone marrow cells, but the cancerous cells, too. Stem cells are then put into the bone marrow via a drip, where they make new blood cells. According to the Hutchinson Cancer Research Center, bone marrow and stem cell transplant procedures have increased the five-year survival rates for CLL from 14 percent in the 1960s to around 75 percent in 2010.
References
- Macmillan Cancer Research: What Is Chronic Lymphocytic Leukaemia?
- Mayoclinic.com: Chronic Lymphocytic Leukemia
- CancerHelpUK: About Chemotherapy for Chronic Lymphocytic Leukaemia (CLL)
- Christie Hospital NHS Foundation Trust: FC (Fludarabine & Cyclophosphamide)
- CancerHelpUK: Biological Therapy for Chronic Lymphocytic Leukaemia (CLL)
