If chronic lymphocytic leukemia isn't at an advanced stage, your doctor may decide treatment is unnecessary at that point, and instead recommend "watchful waiting" and tracking the condition through regular blood testing. Blood tests are performed every 3 months, and at the end of 12 months the medical team will re-evaluate the treatment plan. Treatment may not be needed for years, and then only if the number of lymphocytes increases, the lymph nodes enlarge, or the number of red blood cells or platelets decreases.
Chemotherapy may be used to treat some of the symptoms of chronic lymphocytic leukemia, such as fatigue, anemia, or enlarged lymph nodes. It may be necessary to receive blood or platelet transfusions, depending on the person's blood tests.
Radiation is occasionally used to treat excessive lymph node enlargement. Another treatment option is biologic therapy, which uses a class of medications that help your body's immune system to fight cancer cells.
If anemia develops, it's treated with blood transfusions and injections of erythropoiesis stimulating agents (medications that stimulate red blood cell formation). Low platelet counts are treated with platelet transfusions, and infections with antibiotics. Sometimes the anemia or low platelet count is due to autoimmune effects, where the body's immune system attacks these blood components. This complication is often treated with high doses of steroids, intravenous gamma globulins (a type of protein in the blood), and possibly surgical removal of the spleen.
Sometimes the spleen may be removed (splenectomy) if it has become very large and uncomfortable, or causes anemia as blood flows through it.
Over-treatment of leukemia with certain medications is actually more dangerous than under-treatment because they may cause severe side effects and don't cure the disease or allow people to live longer. Anticancer medications may be prescribed on their own or in combination with corticosteroids, such as prednisone*, when the number of lymphocytes becomes very high. Corticosteroids can cause dramatic improvement in people with advanced leukemia. However, this improvement doesn't usually last long, and long-term use of corticosteroids can produce many negative effects, including an increased risk of getting severe infections.
Bone marrow transplant is an option usually for younger people with severe acute leukemia disease. Those who receive bone marrow transplants must take medications that suppress the body's immune system so that their bodies don't reject the new marrow. However, these medications also put the person at a greater risk for infection. Ways to reduce this risk are under research.
New medications and new combinations of medications are currently being tested that may lead to better, more effective treatments for chronic lymphocytic leukemia, and new procedures for bone marrow transplants are also being studied. Often, it is recommended for people with CLL to enroll in a well-conducted clinical trial in order to receive the most current treatment.
As far as we know, there is nothing that can be done to prevent chronic lymphocytic leukemia.
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