Doctors typically recommend watchful waiting if your CLL is in the early stages and not causing symptoms. Treatment may be considered if you develop persistent fever, night sweats, or extreme fatigue.
Leukemia is classified as either chronic or acute, depending on how quickly it’s expected to develop. Chronic lymphocytic leukemia (CLL) is a slow-growing type of leukemia that develops in a category of white blood cells called lymphocytes.
CLL makes up about
If your doctor decides that treatment isn’t necessary, they’ll likely want to perform regular blood tests to track your disease over time.
Some people with CLL survive more than
Read on to learn more about when CLL requires treatment and what factors determine whether treatment is needed.
CLL can
Your doctor can help you determine whether your CLL requires treatment. They may base the decision based on
- your blood cell count
- whether your liver, spleen, or lymph nodes are enlarged
- your age and overall health when you’re diagnosed
- whether you have symptoms like:
- fever
- chills
- weight loss
- whether you have already received treatment
- whether your CLL has returned
Doctors usually recommend watchful waiting if your CLL isn’t causing symptoms and is expected to progress slowly. Some people who don’t receive treatment have
How staging affects treatment decisions
Doctors use
The RAI classification divides CLL from stages 0 to IV:
| Stage | Description |
|---|---|
| Stage 0 | – elevated levels of lymphocytes |
| Stage I | – elevated levels of lymphocytes – enlarged lymph nodes |
| Stage II | – elevated levels of lymphocytes – possibly enlarged lymph nodes – enlarged spleen or liver |
| Stage III | – elevated levels of lymphocytes – possibly enlarged lymph nodes – possibly enlarged spleen or liver – anemia |
| Stage IV | – elevated levels of lymphocytes – possibly enlarged lymph nodes – possibly enlarged spleen or liver – possibly anemia – low platelet levels |
The Binet classification stages CLL from stage A to C:
| Stage | Description |
|---|---|
| Stage A | – elevated lymphocytes – less than 3 enlarged lymph nodes |
| Stage B | – elevated lymphocytes – more than 3 enlarged lymph nodes |
| Stage C | – any number of enlarged lymph nodes – anemia and/or low platelet levels |
No treatment is
Your doctor may recommend treatment if your CLL is causing symptoms, progressing, or has returned after treatment.
The consensus guidelines of the International Workshop on Chronic Leukemia are largely accepted by doctors to guide when CLL should be treated. According to these guidelines, CLL should be treated in the following cases:
- you develop symptoms like:
- fever over 100.5 degrees F (38.0 C) for more than 2 weeks without evidence of infection
- night sweats for more than a month with no evidence of infection
- unintentional weight loss of more than 10% in the last 6 months
- extreme fatigue
- loss of appetite
- you have more than a 50% increase in the production of lymphocytes over 2 months or a double in your lymphocyte count in less than 6 months.
- you have rapidly progressing signs of disease, like significant increases in the size of your spleen or lymph nodes
- you have autoimmune hemolytic anemia, where your immune system attacks healthy red blood cells
- you have evidence of progressive bone marrow failure, characterized by worsening anemia or low platelet count
- you have reoccurring infections
- watchful waiting
- targeted therapy
- chemotherapy
- radiation therapy
- immunotherapy
- chemotherapy with a bone marrow transplant
Your doctor may also recommend a clinical trial with newer treatment options.
CLL is a slow-growing type of leukemia. It’s very difficult to cure, but many people live for a long time without treatment.
Doctors usually recommend watchful waiting if your CLL is in the early stages and not causing symptoms. Treatment may be necessary if your cancer is getting worse or causing symptoms like fever or weight loss.