Treatment:

No treatment is usually give for early stage CLL. However, the patient must be closely monitored by their health care provider.

If chromosome testing suggests that you have a high-risk type of CLL, treatment may be started earlier.

Treatment may also be started if:

• Infections keep coming back
• Leukemia is growing rapidly.
• Low blood counts (anemia and thrombocytopenia (low platelet count) are present
• Fatigue, loss of appetite, weight loss, or night sweats occur

Several chemotherapy drugs are commonly used to treat CLL.

• Fludarabine, chlorambucil, cyclophosphamide (Cytoxan), and rituximab (Rituxan) may be used alone or in combination.
• Alemtuzumab (Campath) is approved for treatment of patients with CLL that have not responded to fludarabine.
• Bendamustine is a newer drug recently approved for use in patients with CLL that has come back after initial treatment.

Rarely, radiation may be used for painfully enlarged lymph nodes. Blood transfusions or platelet transfusions may be required if blood counts are low.

Bone marrow or stem cell transplantation may be used in younger patients with advanced or high-risk CLL. A transplant is the only therapy that offers a potential cure for CLL.

Expectations (prognosis):

How well a patient does depends on the stage of the cancer. About half of patients diagnosed in the early stages of the disease live more than 12 years.

Complications:

• Autoimmune hemolytic anemia
• Bleeding from low platelet count
• Hypogammaglobulinemia, a condition in which you have lower levels of antibodies, which increases your risk of infection
• Idiopathic thrombocytopenic purpura (ITP)
• Infections that keep coming back (recur)
• Overwhelming fatigue
• Other cancers, including a much more aggressive lymphoma (Richter' s transformation)
• Side effects of chemotherapy

Calling your health care provider:

Call health care provider if you develop enlarged lymph nodes or unexplained fatigue, bruising, excessive sweating, or weight loss.