Treatment is not always required and the patient may just be followed up as an outpatient on a regular basis, sometimes for many years, with no need for further action.
Older people with early stage CLL have a normal life expectancy. Treatment in the form of chemotherapy will be required for those who are unwell or who have many enlarged lymph glands, or who become significantly anaemic.
Chemotherapy is usually given in the form of tablets (usually a medicine called chlorambucil (Leukeran) ). Other chemotherapy drugs such as fludarabine (Fludara) (may be used in late stage disease. General bone marrow production of blood cells can occur in more advanced CLL (bone marrow failure) in which steroid treatment with prednisolone (eg Deltacortril) usually allows the bone marrow to recover. Milder degrees of bone marrow failure might adequately be controlled by periodic blood transfusion.
X-ray treatment (radiotherapy) can be given locally, to swollen lymph nodes, or in small repeated doses to the whole bodyInfections are more common in people with CLL and need to be diagnosed early and treated vigorously.
Sometimes the spleen, which is also part of the body's immune system swells up so much in CLL that it gives rise to pain, or it causes a type of anaemia to develop in which the red cells of the blood (oxygen-carrying cells) become fragile, leading to further anaemia. These problems may justify the surgical removal of the spleen.
Bone marrow transplantation may be considered for those patients who are less than 45 years of age and who have an aggressive form of the disease.
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