Unlike most cancers, chronic lymphocytic leukemia (CLL) is a long-term condition that may not need to be treated for many years. When it is time for treatment, physicians have more options today than ever before to control the disease or put it into remission.
Small lymphocytic lymphoma (SLL) is closely related to CLL. In SLL, cancer cells are found in the lymph nodes and spleen. In CLL, cancer cells are found in the blood and bone marrow. Most of the information in this treatment section about CLL also applies to SLL.
Fred Hutchinson Cancer Center is one of just a few treatment centers in the country that provides every kind of standard therapy for CLL and also gives you access to the latest innovations through clinical trials. Our CLL specialists work closely with you, your family and each other to make the best plan for you.
CLL treatment is highly customized for each patient’s needs.
Your Fred Hutch hematologist-oncologist works with an entire group of doctors who specialize in lymphoid cancers like CLL. They include other hematologist-oncologists, radiation oncologists, bone marrow transplant specialists and researchers who are all looking for better ways to treat this disease.
Every week, this team meets in one room. The meeting is called a tumor board. Together, dozens of team members discuss their patients’ treatment plans. This approach means each patient benefits from the experience of the whole group.
The Fred Hutch experts at these meetings, including your physician, will:
If you have high-risk CLL, we have a dedicated subgroup of providers that focuses on designing your care.
Your care team will walk you and your caregiver through the treatment plan we recommend for you. You will have a chance to share your personal preferences, and you will decide together what happens next.
The treatment plan we design for you depends on many things, including:
These factors guide decisions about which standard therapies and which clinical trials are the best match for you.
Treatment for CLL can be very different from person to person. Patients who do not have symptoms or low blood counts are often on watchful waiting.
If your CLL is getting worse quickly or is higher risk, the standard therapy for most people is targeted therapy or immunotherapy. There are many ways to combine medicines to improve results. Some people with high-risk disease who have already tried other treatments have a blood or marrow transplant.
The goal of active treatment is to put your disease into long-term remission. When you aren’t in remission, the goals are to slow the disease and reduce any symptoms.
At Fred Hutch, our standard therapy always involves caring for you as a whole person. We help you get relief from side effects and provide many other forms of support, like integrative medicine, nutrition counseling and physical therapy.
Our patients can choose to have promising, new CLL therapies that you can get only through a clinical trial. Many people come to Fred Hutch for access to these studies. Your care team will tell you about studies that might be right for you, so you can think about joining them.
Some people with CLL can safely wait years, maybe even decades, to begin active treatment. In fact, some never need treatment at all. If you do need active treatment, we choose, combine and schedule your therapies based on what works for CLL like yours. Your care team makes sure you understand each type of treatment and all of your choices.
While you’re in active treatment, your CLL care team will see you regularly for exams and tests to check:
We update your treatment plan based on the best scientific evidence as well as how your disease responds and what you prefer.
Along with treating your CLL, Fred Hutch provides a range of services to support you and your caregiver, before, during and after treatment. This is part of how we take care of you — not just your disease.
From registered dietitians to social workers to spiritual health staff, we have experts who specialize in caring for people with cancer. We understand this may be one of the most intense and challenging experiences you and your family ever go through. We are here to provide the care you need.
Learn more about Supportive Care
When your disease is in remission and you are not on active treatment, it is still important to get follow-up care on a regular basis. At follow-up visits, you will see the same Fred Hutch team who treated your CLL. They will check your overall health and look for signs that your cancer has come back (signs of recurrence).
Your team will also help with any long-term side effects (which go on after treatment ends) or late effects (which may start after treatment is over).
For people who had a blood or marrow transplant, the Fred Hutch Long-Term Follow-Up Program provides lifelong monitoring and care.