Treatment of CLL

Watchful waiting: Watchful waiting is closely monitoring a patient’s condition without giving any treatment until signs or symptoms appear or change. Treating CLL early does not cure the disease.

Targeted therapy: Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. These include:

• Tyrosine kinase inhibitor (TKI) therapy: This treatment blocks the enzyme, tyrosine kinase, that causes stem cells to develop into more white blood cells than the body needs. Ibrutinib, acalabrutinib, idelalisib, and duvelisib are TKIs used to treat symptomatic or progressive, recurrent, or refractory CLL.
• BCL2 inhibitor therapy: This treatment blocks a protein called BCL2 which is found on some leukemia cells. Venetoclax is a type of BCL2 therapy used in CLL.
• Immunomodulating agent: Lenalidomide stimulates T cells to kill leukemia cells. It may be used alone or with rituximab in patients with CLL.
• Monoclonal antibody therapy: This treatment uses antibodies made in the laboratory from a single type of immune system protein. These antibodies can attach to a specific target on leukemia cells or other cells that may help cancer cells grow. The antibodies are able to then kill the cancer cells or block their growth. Rituximab, ofatumumab, and obinutuzumab are commonly used in CLL.

Chemotherapy: Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Because more effective and safer drugs are now available, chemotherapy is used less commonly to treat CLL.