Chronic Lymphocytic Leukemia - The Leukemia & Lymphoma Society

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These therapies continue to be studied in clinical trials in combination with chemotherapy and other biologic therapies such as lenalidomide (Revlimid®). (see Clinical Trials on page 20). Whereas most chemotherapy affects normal tissue cells as well as CLL cells, monoclonal antibody therapy may affect some normal lymphocytes but spare most other cells. This is particularly true for CD20 antibodies (Rituxan and Arzerra). Even though the infusion of a monoclonal antibody into a patient’s vein may cause a short period of fever, chills or low blood pressure, generally people experience less troubling side effects with monoclonal antibody therapy than with chemotherapy. The drugs most commonly used to treat CLL are shown in Table 3 on page 17. White Cell (neutrophil) Growth Factors. Treatment for CLL may include administering blood cell growth factors to improve low white cell counts. Treatment with white blood cell growth factors may help people with CLL to tolerate the side effects of higher doses of chemotherapy (see Complications: CLL or CLL Treatment on page 18). Radiation Therapy. Radiation is sometimes used to shrink large lymph node masses or masses in locations that interfere with the function of a neighboring body part, such as the kidney, the gastrointestinal tract or the throat. This treatment is rarely used in CLL. Splenectomy. CLL cells can accumulate in the spleen and become problematic in some people with CLL. Surgical removal (splenectomy) of a very enlarged spleen may improve blood cell counts. This approach is used selectively because it is only beneficial if the patient’s spleen is affected by CLL. page 16 I 800.955.4572 I www.LLS.org
Table 3. Some Drugs Used to Treat Chronic Lymphocytic Leukemia { { Bendamustine (Treanda®) { { Chlorambucil (Leukeran®) { { Cladribine (Leustatin®) { { Cyclophosphamide (Cytoxan®) { { Doxorubicin (Adriamycin®) { { Fludarabine (Fludara®) { { Prednisone { { Alemtuzumab (Campath®) { { Ofatumumab (Arzerra®) { { Rituximab (Rituxan®) { { GA101* { { Xm5574* { { TRU-016* Chemotherapy Monoclonal Antibody Therapy Other Drugs { { PCI-32765 (BTK kinase inhibitor)* { { CAL-101 (PI3-kinase inhibitor)* { { Flavopiridol (CDK kinase inhibitor)* { { Dinaciclib (CDK kinase inhibitor)* { { Lenalidomide (Revlimid®)* [immunomodulator] * Under study in clinical trials Relapsed or Refractory CLL. “Relapsed CLL” is the term for disease that responded to therapy but, after six or more months, stopped responding. “Refractory disease” is the term for CLL that does not result in a remission (but may be stable) or disease that gets worse within six months of the last treatment. People who are treated for relapsed or refractory CLL often have good quality years of remission after more treatment. Treatment guidelines for people with relapsed CLL are generally the same as treatment for newly diagnosed people. People who have refractory CLL with a short time to progression after the first treatment and/or CLL cells with del 17p often do not respond to standard chemotherapy. These people are advised to speak to their doctors about whether or not treatment in a clinical trial is a good option for them. Investigative clinical protocols for drug therapies or allogeneic stem cell transplantation may offer appropriate treatment options (see Clinical Trials on page 20). Chronic Lymphocytic Leukemia I page 17
Page 1 and 2: Chronic Lymphocytic Leukemia JUNE D
Page 3 and 4: Table of Contents 2 Introduction 2
Page 5 and 6: along with a cancer diagnosis. LLS
Page 7 and 8: We’d Like to Hear From You. We ho
Page 9 and 10: etween herbicides used in Vietnam a
Page 11 and 12: infrequently, cause an increase in
Page 13 and 14: Chromosomal Changes. Certain chromo
Page 15 and 16: Treatment Current therapies do not
Page 17: Chemotherapy. Chlorambucil (Leukera
Page 21 and 22: Prolymphocytes. About 15 percent of
Page 23 and 24: Kinase Inhibitor Therapy. Kinases a
Page 25 and 26: The National Cancer Institute-spons
Page 27 and 28: Table 5. CLL and Related Diseases L
Page 29 and 30: { { The neutrophils and monocytes a
Page 31 and 32: Medical Terms Allogeneic Stem Cell
Page 33 and 34: Bone Marrow Biopsy. A test to exami
Page 35 and 36: e counted. One use of flow cytometr
Page 37 and 38: HLA. The abbreviation for “human
Page 39 and 40: egg or the sperm and can be transmi
Page 41 and 42: Promyelocyte. A cell that is formed
Page 43 and 44: More Information Free LLS publicati
Page 45 and 46: Notes Chronic Lymphocytic Leukemia
Page 47 and 48: REACH OUT TO OUR INFORMATION SPECIA

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