Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is a cancer of the bone marrow and blood. It is also called chronic lymphoid leukemia. It happens when a type of white blood cell called a lymphocyte changes and grows out of control. Small lymphocytic lymphoma (SLL) is closely related to CLL. But in SLL, cancer cells are found in the lymph nodes and spleen. Most of the information in our web section about CLL also applies to SLL.

Fred Hutchinson Cancer Center provides all standard therapies for CLL. Our experts are national leaders in CLL research and have developed many of these approaches. 

Many of our CLL patients join clinical trials — led by world-renowned physicians from Fred Hutch and UW Medicine — to get promising therapies that are not available anywhere else.

We also treat other rare types of leukemia or lymphoma that come from lymphocytes. These include prolymphocytic leukemia, large granular lymphocytic leukemia and hairy cell leukemia. 

Fred Hutch: A Leader in Leukemia Treatment

Many people with CLL do well without treatment for years. But in some cases, getting treatment right away is essential. To protect your health, it’s important to work with CLL experts who know how to get you the right care soon after diagnosis. We understand the complex details that go into planning the right approach for each person, like whether you need treatment at all, and if so, what kinds of treatment you need and when. Our deep experience means the best care for you.

Your First Appointment

From the first time you come to see us, your CLL team will begin getting to know you and your family. What are your questions? What are your concerns? 

At your first appointment, your hematologist-oncologist will also explain your specific disease. They will talk with you about if you need to begin active treatment and how your care will be customized to you. Before you leave, your team makes sure you understand the next steps.

Learn About CLL

Diagnosing CLL involves a series of blood tests, and sometimes a bone marrow biopsy, which shows if you have cancer. The biopsy gives details about the type and subtype of cancer you have. 

At Fred Hutch, our experts check and confirm your cancer type and the molecular features of your subtype. We also look for factors that tell us if your CLL is likely to get worse (called high-risk disease). This information matters in planning your personalized care. 

Facts & Resources


Often, CLL grows slowly. It may not cause any symptoms or other health concerns for years. But in some cases, it grows faster, and getting treatment quickly matters. To know the outlook in your case and to plan the right approach for you, it’s important to work with CLL specialists.

We offer watchful waiting, if that matches your needs, as well as every standard therapy for CLL. These include targeted therapy, immunotherapy and bone marrow transplant. Novel (new) therapies are available here, too. Because of recent advancements in treating CLL, chemotherapy is rarely used now.


CLL Care Team

As you go through treatment, your needs may change. Your care team at Fred Hutch is with you each step of the way. For example, we will help you deal with any side effects you have from treatment. We may suggest adding a new therapy that was just approved. To protect your health over the long term, we will keep seeing you as long as you need us.

Your care team will design a treatment plan specifically for — and with — you. At Fred Hutch, doctors with knowledge and experience in CLL will design and provide your care.

Care Team

Our Approach to Treatment

The safest, most effective and most widely accepted therapies for cancer are known as the “standard of care.” For many patients, these therapies will be a large part of their treatment. At Fred Hutch, we provide all standard therapies for CLL. We know how to choose the right ones for you and how to deliver them to give you the best chance at getting to remission.

Our physicians and researchers are always asking how we can make CLL treatments more effective and reduce side effects as much as possible. This is why we do clinical trials (also called clinical studies). Through these studies, we are able to offer you therapies that aren’t available everywhere. A therapy that is going through trials today may become the new standard of care tomorrow.

Along with treating your cancer, a group of world-class professionals is here to support you. This team includes nurses, dietitians, physical therapists, social workers and psychologists. We also include supportive care services for your physical, mental and emotional well-being. 

caregiver with family member

Role of the Caregiver

When someone close to you needs treatment for CLL, you might step into the role of caregiver. Being a caregiver can mean many things, from lending a hand with daily living tasks to helping with medical decisions. It can also mean dealing with your own emotions and stress.

At Fred Hutch, caregivers are valuable members of a patient’s care team. We see every day that your presence and your support make a difference. We know that what your friend or family member is going through affects you, too.

Part of our mission is to help you take care of yourself. Caring for yourself is good for your own physical, mental and emotional health. It also helps you give your best to your loved one. Our social workers, Spiritual Health team and Patient and Family Resource Center staff are here to help support you.

Latest Treatments and Clinical Trials

Physicians and scientists from Fred Hutch and UW Medicine are testing new treatments for CLL and SLL and finding new ways to use current treatments. 

Through this work, we are looking for answers to two main questions: How can we do even better at controlling these diseases? How can we make treatments less toxic and easier on patients?

We have been part of, and led, many clinical trials of promising therapies that later became the standard of care.

We have many clinical trials testing dozens of approaches to CLL/SLL. Some of the therapies we are studying are:

  • Early intervention for people with high-risk CLL
  • Novel (new) targeted therapies and new combinations that get good results, even though they only need to be taken for a limited time
  • Immunotherapies, including antibody therapies, immune checkpoint inhibitors and cellular immunotherapies, like CAR T-cell therapy
  • Blood and marrow transplant regimens (treatment plans)

When your care team designs your treatment plan, they will give you the choice to join clinical trials that match your situation. If you decide to join one, you will see the same physicians and nurses as you would for standard therapy.

Your care team will talk with you about if you might want to join a study and why. This can help you make the decision that is best for you.

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