Overview of the treatment of chronic lymphocytic leukemia
- Kanti R Rai, MD
Kanti R Rai, MD
- Professor of Medicine and Molecular Medicine
- Hofstra North Shore-LIJ School of Medicine at Hofstra University
- Stephan Stilgenbauer, MD
Stephan Stilgenbauer, MD
- Professor of Medicine
- Ulm University
Chronic lymphocytic leukemia (CLL) is one of the chronic lymphoproliferative disorders (lymphoid neoplasms). It is characterized by a progressive accumulation of functionally incompetent lymphocytes, which are usually monoclonal in origin.
CLL is considered to be identical (ie, one disease with different manifestations) to the mature (peripheral) B cell neoplasm small lymphocytic lymphoma (SLL), one of the indolent non-Hodgkin lymphomas. The term CLL is used when the disease manifests primarily in the blood, whereas the term SLL is used when involvement is primarily nodal. While there is some difference to the treatment of early stage CLL and SLL, the treatment of advanced stage disease is the same. (See "Clinical presentation, pathologic features, diagnosis, and differential diagnosis of chronic lymphocytic leukemia".)
General issues regarding the treatment of CLL/SLL will be reviewed here. Further details regarding the selection of initial therapy for advanced stage or symptomatic disease, the treatment of relapsed/refractory disease, the use of hematopoietic cell transplantation, and the management of complications of CLL/SLL and its treatment are discussed separately. (See "Selection of initial therapy for symptomatic or advanced chronic lymphocytic leukemia" and "Treatment of relapsed or refractory chronic lymphocytic leukemia" and "Hematopoietic cell transplantation in chronic lymphocytic leukemia" and "Overview of the complications of chronic lymphocytic leukemia".)
The pathophysiology, clinical manifestations, diagnosis, staging, and prognosis of CLL and SLL are also discussed separately. (See "Clinical presentation, pathologic features, diagnosis, and differential diagnosis of chronic lymphocytic leukemia" and "Staging and prognosis of chronic lymphocytic leukemia" and "Pathophysiology and genetic features of chronic lymphocytic leukemia".)
INDICATIONS FOR TREATMENT
Not all patients with CLL require treatment at the time of diagnosis. This is principally because:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- INDICATIONS FOR TREATMENT
- Asymptomatic early stage
- Symptomatic or advanced stage
- MANAGEMENT OF CLL/SLL
- Management of asymptomatic CLL
- Treatment of localized SLL
- Treatment of symptomatic CLL or advanced SLL
- - Pre-treatment evaluation
- - Selection of therapy
- Management of the complications of CLL and its therapy
- EVALUATING RESPONSE TO TREATMENT
- DURATION OF THERAPY
- RELAPSED DISEASE
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS