How is CLL treated?

The treatment chosen for your disease will depend on several factors including the stage of your disease, whether or not you have symptoms of your disease, how quickly your disease is progressing, and your age and general health. Traditionally the Rai and Binet staging systems have been used to estimate prognosis in CLL. Using these systems, patients are assigned to one of three major subgroups:

• Stage A (0) refers to early disease where in many cases people haven’t got any symptoms and don’t require treatment
• Stage B (I-II) & C (III-IV) refer to more advance disease which usually requires treatment.

Increasingly, treatment decisions may be influenced by many prognostic factors, which may put some people at a higher risk of disease progression than others regardless of the stage of their disease. In helping you make the best treatment decision, your doctor will consider all information available, including the details of your particular situation, to prescribe the best course of treatment. If treatment is needed the principle aims of treatment are two-fold: to bring about a long-lasting remission, and to prevent and reduce symptoms of the disease.

Many people with CLL, particularly in the early stages of disease, have no symptoms and don’t require any treatment. Instead the doctor may recommend an ‘actively monitor’ strategy (sometimes called ‘watch and wait’) involving regular check-ups and blood counts to carefully monitor your health. This strategy may also be appropriate in more advanced stages of CLL if your blood counts remain stable.

Treatment usually starts only once the disease begins to progress, or causes troublesome symptoms. Many people with CLL have the disease for years without it causing any problems and some people diagnosed with CLL will never require any treatment. There is a general agreement that most people with advanced stage CLL (Rai III and IV, Binet B and C) will need to be treated. Treatment may involve the use of:

• chemotherapy
• monoclonal antibody therapy
• stem cell transplantation
• experimental treatments available through clinical trials.

The latest CLL treatments and therapies with Dr Jan Burger

Warren’s CLL Story

Warren’s story isn’t unusual – prior to his 2003 diagnosis, he had no awareness of blood cancer, let alone chronic lymphocytic leukaemia (CLL). After seven rounds of chemotherapy, a bone marrow biopsy indicated he was running out of options. Until he learned of a targeted oral therapy overseas. The therapy was brought to Australia as part of a clinical trial and Warren was fortunate enough to be able to access the treatment that has kept him alive.