Treatment

Your treatment options for chronic lymphocytic leukemia depend on several factors, such as the stage of your cancer, whether you're experiencing signs and symptoms, your overall health, and your preferences.

Treatment may not be necessary in early stages

People with early-stage chronic lymphocytic leukemia typically don't receive treatment, though clinical trials are evaluating whether early treatment may be helpful. Studies have shown that early treatment doesn't extend lives for people with early-stage chronic lymphocytic leukemia.

Rather than put you through the potential side effects and complications of treatment before you need it, doctors carefully monitor your condition and reserve treatment for when your leukemia progresses. Doctors call this watchful waiting.

Your doctor will plan a checkup schedule for you. You may meet with your doctor and have your blood tested every few months to monitor your condition.

Treatments for intermediate and advanced stages

If your doctor determines your chronic lymphocytic leukemia is progressing or is in the intermediate or advanced stages, your treatment options may include:

  • Chemotherapy. Chemotherapy is a drug treatment that kills cancer cells. Chemotherapy treatments can be administered through a vein or taken in pill form. Depending on your situation, your doctor may use a single chemotherapy drug or you may receive a combination of drugs.
  • Targeted drug therapy. Targeted drugs are designed to take advantage of the specific vulnerabilities of your cancer cells. Targeted therapy drugs used in treating chronic lymphocytic leukemia include alemtuzumab (Campath), ibrutinib (Imbruvica), idelalisib (Zydelig), lenalidomide (Revlimid), obinutuzumab (Gazyva), ofatumumab (Arzerra) and rituximab (Rituxan).

    Other targeted therapies are being studied in clinical trials.

  • Bone marrow stem cell transplant. Bone marrow stem cell transplants use strong chemotherapy drugs to kill the stem cells in your bone marrow that are creating diseased lymphocytes. Then healthy adult blood stem cells from a donor are infused into your blood, where they travel to your bone marrow and begin making healthy blood cells.

    A reduced intensity, or "mini," bone marrow stem cell transplant is similar to a standard stem cell transplant, but it uses lower doses of chemotherapy drugs.

    Bone marrow stem cells may be a treatment option in certain cases when other treatments haven't worked or for certain cases of very aggressive forms of chronic lymphocytic leukemia.

Supportive care

Your doctor will meet with you regularly to monitor any complications you may experience. Supportive care measures may help prevent or relieve any signs or symptoms. Supportive care may include:

  • Cancer screening. Your doctor will evaluate your risk of other types of cancer and may recommend screening to look for signs of other cancers. For instance, your doctor may recommend an annual skin examination to look for signs of skin cancer.
  • Vaccinations to prevent infections. Your doctor may recommend certain vaccinations to reduce your risk of infections, such as pneumonia and influenza.
  • Monitoring for other health problems. Your doctor may recommend regular checkups to monitor your health during and after treatment for chronic lymphocytic leukemia.
  • Palliative care. Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.

Alternative medicine

No alternative treatments have been proved to cure chronic lymphocytic leukemia.

Alternative treatments for coping with fatigue

Some alternative medicine therapies may help you cope with fatigue, which is commonly experienced by people with chronic lymphocytic leukemia. Your doctor can treat fatigue by controlling the underlying causes, but often medications alone aren't enough. You may find relief through alternative therapies, such as:

  • Exercise
  • Massage
  • Meditation
  • Relaxation techniques
  • Yoga

Talk to your doctor about your options. Together you can devise a plan to help you cope with fatigue.

Green tea extracts for people with early-stage leukemia

A green tea extract has shown some promise in initial clinical trials for treating chronic lymphocytic leukemia. Laboratory research determined that a compound in green tea extract, called EGCG, can kill chronic lymphocytic leukemia cells.

In a study of people with early-stage chronic lymphocytic leukemia, taking EGCG in pill form reduced some signs of the disease in a portion of the participants. For instance, some participants noticed that their enlarged lymph nodes decreased in size, and blood tests revealed some participants had fewer leukemia cells in their blood. Research into EGCG and green tea is ongoing.

April 19, 2016
References
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