Chronic lymphocytic Leukaemia Treatment Explained

What are the treatment options for chronic lymphocytic leukaemia?

The primary treatment options for chronic lymphocytic leukaemia (CLL) are immunotherapy, targeted therapies and chemotherapy. In many cases, CLL patients may never need treatment as long as you do not experience symptoms. When treatment is needed, the type of treatment you receive will depend on a number of different considerations, such as the stage of your cancer, your overall health and your treatment preferences. This page aims to give you a comprehensive overview of how chronic lymphocytic leukaemia treatment works.

Types of chronic lymphocytic leukaemia treatment

Chemotherapy
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Targeted therapies
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Immunotherapy
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Chemotherapy for chronic lymphocytic leukaemia

Chemotherapy is the primary treatment for CLL, which involves the use of a range of drugs to kill and slow the growth of chronic lymphocytic leukaemia cells. Depending on the type of CLL you have and your age, you may have different treatment options.

Learn more about chemotherapy and how it is delivered.

Targeted therapies for chronic lymphocytic leukaemia

Targeted therapies use specialised drugs to destroy CLL cells by targeting abnormalities found within cancer cells while avoiding normal, healthy cells. Targeted therapies are the preferred treatment for people with CLL with genetic changes known as TP53 mutation or 17p deletion.

Immunotherapy for acute lymphoblastic leukaemia

Immunotherapy trains your body’s own immune system to recognise and fight chronic lymphocytic leukaemia cells.

Monoclonal antibody drugs are a type of immunotherapy treatment which target a protein called CD20 on the surface of certain white blood cells called B-lymphocytes (B-cells). When they attach to the CD20 protein, which are present on the B cells of people with chronic lymphocytic leukaemia, this allows your own immune system to recognise and target cancer cells and destroy them.

Treatment by stage of chronic lymphocytic leukaemia

When you are diagnosed with CLL, your haematologist will develop your treatment plan as part of a multidisciplinary team based on the stage of your cancer. In many cases, CLL patients may never need treatment as long as they do not experience symptoms. Common treatment options for each stage of CLL include:

Stage 0 chronic lymphocytic leukaemia

While CLL is in stage 0, lymphocyte levels in your blood are high but no other symptoms of leukaemia are present. No treatment is typically need at this stage and your haematologist will likely recommend active monitoring.

Stage I chronic lymphocytic leukaemia

Stage I CLL is similar to stage 0 as lymphocyte levels are high, although lymph nodes may be larger than normal. Again, no treatment is typically needed at this stage.

Stage II chronic lymphocytic leukaemia

In stage II CLL it is also common for the liver and spleen to become swollen, alongside elevated lymphocytes in the blood and swollen lymph nodes. Depending on the severity of your symptoms and the level of lymphocytes in your blood, your haematologist may recommend that you begin treatment.

Stage III chronic lymphocytic leukaemia

Once CLL reaches stage III, lymphocytes remain elevated and your red blood cell count will have decreased, resulting in anaemia. While platelet counts will remain normal, your disease has reached an advanced and high-risk stage that now requires treatment. The first step in treatment for CLL is to lower lymphocyte levels which can be done in a number of ways. Some options include chemotherapy, targeted therapy, immunotherapy or a combination of these. Very rarely you may need leukapheresis treatment, which involves passing your blood through a machine to remove white blood cells and returning the remaining blood back to your body, as increased CLL cells in your blood stream can also cause issues with circulation.

Stage IV chronic lymphocytic leukaemia

When CLL progresses to stage IV, all previous symptoms may be present, but platelet levels will have also fallen making it difficult for blood to clot. Similarly to stage III this requires the initiation of treatment.