Treatment of Chronic Lymphocytic Leukaemia
Treatment of chronic lymphocytic leukaemia is tailored to the individual. Taking into account their age, general health, symptoms, and genetic markers. Because chronic lymphocytic leukaemia often progresses slowly, many patients do not need immediate therapy. Instead, doctors may recommend “watchful waiting” with regular monitoring until signs of disease progression emerge.
The decision to begin treatment usually depends on the presence of symptoms such as significant fatigue, weight loss, night sweats, rapidly increasing lymphocyte counts, or complications like anaemia or thrombocytopenia. Enlarged lymph nodes or spleen that cause discomfort or organ dysfunction may also prompt treatment.
1. Chemotherapy
Doctors have used traditional chemotherapy drugs—fludarabine, cyclophosphamide, and chlorambucil—to treat CLL for decades. These agents work by targeting and destroying rapidly dividing cells, but they also affect healthy cells, leading to side effects like nausea, fatigue, and increased infection risk.
2. Targeted Therapy | Treatment of Chronic Lymphocytic Leukaemia
Modern treatment often focuses on targeted drugs that interfere with specific molecules or pathways in cancer cells. These therapies include:
- Ibrutinib: A Bruton’s tyrosine kinase (BTK) inhibitor that blocks signals cancer cells need to survive.
- Venetoclax: Targets the BCL-2 protein, promoting cell death in CLL cells.
- Acalabrutinib and zanubrutinib: Newer BTK inhibitors with fewer cardiac side effects.
Taken orally, these medications have reshaped CLL treatment by delivering strong results with fewer side effects than standard chemotherapy.
3. Monoclonal Antibodies
These laboratory-produced proteins bind to specific targets on cancer cells. Examples include:
- Rituximab
- Obinutuzumab
- Ofatumumab
They can be used alone or in combination with chemotherapy or targeted drugs to enhance response rates.
4. Stem Cell Transplant
In rare, aggressive cases — particularly those with high-risk genetic mutations like 17p deletion — allogeneic stem cell transplantation may be considered. This option is generally reserved for younger, fit patients who haven’t responded to other treatments.
5. Clinical Trials
Participation in clinical research offers access to cutting-edge therapies. Many trials focus on combining drugs or testing new targeted treatments with fewer side effects.
6. Supportive Care | Treatment of Chronic Lymphocytic Leukaemia
Management of infections, anaemia, and other symptoms is a critical part of CLL treatment. Prophylactic antibiotics, antiviral agents, blood transfusions, and immunoglobulin therapy may be used as needed.
Treatment response is assessed using blood tests, physical exams, and imaging. Some patients achieve remission, while others experience relapses that require different therapies over time.
Overall, treatment of chronic lymphocytic leukaemia has advanced significantly. Patients now have more options than ever, with many living long, high-quality lives thanks to improved, personalised care strategies.
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