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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK66050_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK66050_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK66050_"><span class="title" itemprop="name">Chronic Lymphocytic Leukemia Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: December 30, 2014.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000258005__183">This PDQ cancer information summary has current information about the treatment of chronic lymphocytic leukemia. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000258005__184">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000258005__1"><h2 id="_CDR0000258005__1_">General Information About Chronic Lymphocytic Leukemia</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258005__2">Chronic lymphocytic leukemia is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258005__172">Leukemia may affect red blood cells, white blood cells, and platelets.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258005__10">Older age can affect the risk
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of developing chronic lymphocytic leukemia.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258005__13">Signs and symptoms of chronic lymphocytic leukemia include swollen lymph nodes and tiredness. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258005__17">Tests that examine the blood, bone marrow, and lymph nodes are used to detect
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(find) and diagnose chronic lymphocytic leukemia.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258005__21">Certain factors affect treatment options and prognosis (chance
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of recovery).</a></div></li></ul></div><div id="CDR0000258005__2"><h3>Chronic lymphocytic leukemia is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).</h3><p id="CDR0000258005__116">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044846/" class="def">Chronic lymphocytic leukemia</a> (also called CLL) is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045622/" class="def">bone marrow</a> disease that usually gets worse slowly. CLL is one of the most common types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045343/" class="def">leukemia</a> in adults. It often occurs during or after middle age; it rarely occurs in children.
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</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000258005182" co-legend-rid="figlgndCDR0000258005182"><a href="/books/NBK66050.1/figure/CDR0000258005__182/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000258005182" rid-ob="figobCDR0000258005182"><img class="small-thumb" src="/books/NBK66050.1/bin/CDR0000755927.gif" src-large="/books/NBK66050.1/bin/CDR0000755927.jpg" alt="Anatomy of the bone" /></a><div class="icnblk_cntnt" id="figlgndCDR0000258005182"><h4 id="CDR0000258005__182"><a href="/books/NBK66050.1/figure/CDR0000258005__182/?report=objectonly" target="object" rid-ob="figobCDR0000258005182">Figure</a></h4><p class="float-caption no_bottom_margin">Anatomy of the bone. The bone is made up of compact bone, spongy bone, and bone marrow. Compact bone makes up the outer layer of the bone. Spongy bone is found mostly at the ends of bones and contains red marrow. Bone marrow is found in the center of <a href="/books/NBK66050.1/figure/CDR0000258005__182/?report=objectonly" target="object" rid-ob="figobCDR0000258005182">(more...)</a></p></div></div></div><div id="CDR0000258005__172"><h3>Leukemia may affect red blood cells, white blood cells, and platelets.</h3><p id="CDR0000258005__174">Normally, the body makes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000765906/" class="def">blood stem cells</a> (immature <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>) that become mature blood cells over time. A blood stem cell may become a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046279/" class="def">myeloid</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046598/" class="def">stem cell</a> or a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046298/" class="def">lymphoid</a> stem cell.</p><p id="CDR0000258005__175">A myeloid stem cell becomes one of three types of mature blood cells:</p><ul id="CDR0000258005__176"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046124/" class="def">Red blood cells</a> that carry <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538149/" class="def">oxygen</a> and other substances to all <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> of the
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body.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">White blood cells</a> that fight <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a> and disease. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045840/" class="def">Platelets</a> that form <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476017/" class="def">blood clots</a> to stop bleeding.</div></li></ul><p id="CDR0000258005__177">A lymphoid stem cell becomes a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000302475/" class="def">lymphoblast</a> cell and then one of three types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045765/" class="def">lymphocytes</a> (white blood cells):</p><ul id="CDR0000258005__178"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044953/" class="def">B lymphocytes</a> that make <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> to help fight infection.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044928/" class="def">T lymphocytes</a> that help B lymphocytes make antibodies to fight infection.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044062/" class="def">Natural killer cells</a> that attack <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> cells and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045941/" class="def">viruses</a>.</div></li></ul><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000258005153" co-legend-rid="figlgndCDR0000258005153"><a href="/books/NBK66050.1/figure/CDR0000258005__153/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000258005153" rid-ob="figobCDR0000258005153"><img class="small-thumb" src="/books/NBK66050.1/bin/CDR0000526538.gif" src-large="/books/NBK66050.1/bin/CDR0000526538.jpg" alt="Blood cell development" /></a><div class="icnblk_cntnt" id="figlgndCDR0000258005153"><h4 id="CDR0000258005__153"><a href="/books/NBK66050.1/figure/CDR0000258005__153/?report=objectonly" target="object" rid-ob="figobCDR0000258005153">Figure</a></h4><p class="float-caption no_bottom_margin">Blood cell development. A blood stem cell goes through several steps to become a red blood cell, platelet, or white blood cell. </p></div></div><p id="CDR0000258005__179">In CLL, too many blood stem cells become <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> lymphocytes and do not become healthy white blood cells. The abnormal lymphocytes may also be called leukemia cells. The lymphocytes are not able to fight infection very well. Also, as the number of lymphocytes increases in the blood and bone marrow, there is less room for healthy white blood cells, red blood cells, and platelets. This may cause infection, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045360/" class="def">anemia</a>, and easy bleeding.</p><p id="CDR0000258005__180"> This summary is about chronic lymphocytic leukemia.
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See the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summaries for more information about leukemia: </p><ul id="CDR0000258005__181"><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000257989/">Adult Acute Lymphoblastic Leukemia Treatment</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000258001/">Childhood Acute Lymphoblastic Leukemia Treatment</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000257990/">Adult Acute Myeloid Leukemia Treatment</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000258000/">Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000258006/">Chronic Myelogenous Leukemia Treatment</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000258013/">Hairy Cell Leukemia Treatment</a>.</div></li></ul></div><div id="CDR0000258005__10"><h3>Older age can affect the risk
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of developing chronic lymphocytic leukemia.</h3><p id="CDR0000258005__12">Anything that increases your risk of getting a disease is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045873/" class="def">risk factor</a>. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for CLL include the following:</p><ul id="CDR0000258005__119"><li class="half_rhythm"><div>Being middle-aged or older, male, or white.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000302456/" class="def">family history</a> of CLL or cancer of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045764/" class="def">lymph system</a>.</div></li><li class="half_rhythm"><div>Having relatives who are Russian Jews or Eastern European Jews.</div></li></ul></div><div id="CDR0000258005__13"><h3>Signs and symptoms of chronic lymphocytic leukemia include swollen lymph nodes and tiredness. </h3><p id="CDR0000258005__15">Usually CLL does not cause any <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and is found during a routine <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000688783/" class="def">blood test</a>. Signs and symptoms may be caused by CLL or by other
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a>. Check with your doctor if you have any of the following:</p><ul id="CDR0000258005__16"><li class="half_rhythm"><div>Painless swelling of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> in the neck, underarm, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046375/" class="def">groin</a>.</div></li><li class="half_rhythm"><div>Feeling very tired.</div></li><li class="half_rhythm"><div>Pain or fullness below the ribs.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450108/" class="def">Fever</a> and infection.</div></li><li class="half_rhythm"><div>Weight loss for no known reason.</div></li></ul></div><div id="CDR0000258005__17"><h3>Tests that examine the blood, bone marrow, and lymph nodes are used to detect
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(find) and diagnose chronic lymphocytic leukemia.</h3><p id="CDR0000258005__134">The following tests and procedures may be used:</p><ul id="CDR0000258005__19"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689078/" class="def">history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000729979/" class="def">Complete blood
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count (CBC) with differential</a></b>: A procedure in which a sample of blood is drawn and
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checked for the following:
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<dl id="CDR0000258005__20" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">
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The number of red blood cells and platelets.</p></dd><dt>-</dt><dd><p class="no_top_margin">The number and type of white blood cells.</p></dd><dt>-</dt><dd><p class="no_top_margin">The amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045108/" class="def">hemoglobin</a> (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a> that carries oxygen) in the red blood cells.</p></dd><dt>-</dt><dd><p class="no_top_margin">The portion of the blood sample made up of red blood cells.
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</p></dd></dl><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000258005148" co-legend-rid="figlgndCDR0000258005148"><a href="/books/NBK66050.1/figure/CDR0000258005__148/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000258005148" rid-ob="figobCDR0000258005148"><img class="small-thumb" src="/books/NBK66050.1/bin/CDR0000526546.gif" src-large="/books/NBK66050.1/bin/CDR0000526546.jpg" alt="Complete blood count (CBC)" /></a><div class="icnblk_cntnt" id="figlgndCDR0000258005148"><h4 id="CDR0000258005__148"><a href="/books/NBK66050.1/figure/CDR0000258005__148/?report=objectonly" target="object" rid-ob="figobCDR0000258005148">Figure</a></h4><p class="float-caption no_bottom_margin">Complete blood count (CBC). Blood is collected by inserting a needle into a vein and allowing the blood to flow into a tube. The blood sample is sent to the laboratory and the red blood cells, white blood cells, and platelets are counted. The CBC is used <a href="/books/NBK66050.1/figure/CDR0000258005__148/?report=objectonly" target="object" rid-ob="figobCDR0000258005148">(more...)</a></p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000341450/" class="def">Immunophenotyping</a></b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046590/" class="def">laboratory test</a> in which the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046086/" class="def">antigens</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045776/" class="def">markers</a> on the surface of a blood or bone marrow cell are checked to see if they are lymphocytes or myeloid cells. If the cells are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a> lymphocytes (cancer), they are checked to see if they are B lymphocytes or T lymphocytes.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000460228/" class="def">FISH</a> (fluorescence in situ hybridization)</b>: A laboratory technique used to look at <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">genes</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046470/" class="def">chromosomes</a> in cells and tissues. Pieces of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045671/" class="def">DNA</a> that contain a fluorescent dye are made in the laboratory and added to cells or tissues on a glass slide. When these pieces of DNA bind to specific genes or areas of chromosomes on the slide, they light up when viewed under a microscope with a special light.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335066/" class="def">Flow cytometry</a></b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046590/" class="def">laboratory test</a> that measures the number of cells in a sample, the percentage of live cells in a sample, and certain characteristics of cells, such as size, shape, and the presence of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046636/" class="def">tumor markers</a> on the cell surface. The cells are stained with a light-sensitive dye, placed in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a>, and passed in a stream before a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045748/" class="def">laser</a> or other type of light. The measurements are based on how the light-sensitive dye reacts to the light.</div></li><li class="half_rhythm"><div><b><i>IgVH</i> gene <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046063/" class="def">mutation</a> test</b>: A laboratory test done on a bone marrow or blood sample to check for an <i>IgVH</i> gene mutation. Patients with an <i>IgVH</i> gene mutation have a better <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a>.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046505/" class="def">Bone marrow aspiration</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046506/" class="def">biopsy</a></b>: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000549425/" class="def">breastbone</a>. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the bone marrow, blood, and bone under a microscope to look for abnormal cells.<div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000258005160" co-legend-rid="figlgndCDR0000258005160"><a href="/books/NBK66050.1/figure/CDR0000258005__160/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000258005160" rid-ob="figobCDR0000258005160"><img class="small-thumb" src="/books/NBK66050.1/bin/CDR0000554337.gif" src-large="/books/NBK66050.1/bin/CDR0000554337.jpg" alt="Bone marrow aspiration and biopsy" /></a><div class="icnblk_cntnt" id="figlgndCDR0000258005160"><h4 id="CDR0000258005__160"><a href="/books/NBK66050.1/figure/CDR0000258005__160/?report=objectonly" target="object" rid-ob="figobCDR0000258005160">Figure</a></h4><p class="float-caption no_bottom_margin">Bone marrow aspiration and biopsy. After a small area of skin is numbed, a bone marrow needle is inserted into the patient’s hip bone. Samples of blood, bone, and bone marrow are removed for examination under a microscope. </p></div></div></div></li></ul></div><div id="CDR0000258005__21"><h3>Certain factors affect treatment options and prognosis (chance
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of recovery).</h3><p id="CDR0000258005__140">Treatment options depend on:</p><ul id="CDR0000258005__135"><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the disease.</div></li><li class="half_rhythm"><div>Red blood cell, white blood cell, and platelet blood counts.</div></li><li class="half_rhythm"><div>Whether there are signs or symptoms, such as fever, chills, or weight loss.</div></li><li class="half_rhythm"><div>Whether the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a>, or lymph nodes are larger than normal.</div></li><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044085/" class="def">response</a> to initial treatment.</div></li><li class="half_rhythm"><div>Whether the CLL has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back).</div></li></ul><p id="CDR0000258005__141">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> (chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>) depends on:</p><ul id="CDR0000258005__137"><li class="half_rhythm"><div>Whether there is a change in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045671/" class="def">DNA</a> and the type of change, if there is one.</div></li><li class="half_rhythm"><div>Whether lymphocytes are spread throughout the bone marrow.</div></li><li class="half_rhythm"><div>The stage of the disease.</div></li><li class="half_rhythm"><div>Whether the CLL gets better with treatment or has recurred (come back).</div></li><li class="half_rhythm"><div>Whether the CLL <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044078/" class="def">progresses</a> to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045368/" class="def">lymphoma</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045380/" class="def">prolymphocytic leukemia</a>.</div></li><li class="half_rhythm"><div>The patient's general health.</div></li></ul></div></div><div id="CDR0000258005__24"><h2 id="_CDR0000258005__24_">Stages of Chronic Lymphocytic Leukemia</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258005__25">After chronic lymphocytic leukemia has been diagnosed, tests
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are done to find out how far the cancer has spread in the blood and bone marrow. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258005__29">The following stages are used for chronic lymphocytic
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leukemia:</a></div></li></ul></div><div id="CDR0000258005__25"><h3>After chronic lymphocytic leukemia has been diagnosed, tests
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are done to find out how far the cancer has spread in the blood and bone marrow. </h3><p id="CDR0000258005__27"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">Staging</a> is the process used to find out how far the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread. It is important to know the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the disease in order to plan the best treatment. The following tests may be used in the staging process:</p><ul id="CDR0000258005__28"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304687/" class="def">Chest x-ray</a></b>: An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic resonance imaging)</b>: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the brain and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">spinal cord</a>. This procedure is also called nuclear magnetic resonance imaging (NMRI).</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or swallowed to help the organs or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304685/" class="def">Blood chemistry studies</a></b>: A procedure in which a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">sign</a> of disease in the organ or tissue that makes it.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000341451/" class="def">Antiglobulin test</a></b>: A test in which a sample of blood is looked at under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to find out if there are any <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> on the surface of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046124/" class="def">red blood cells</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045840/" class="def">platelets</a>. These antibodies may react with and destroy the red blood cells and platelets. This test is also called a Coombs test.</div></li></ul></div><div id="CDR0000258005__29"><h3>The following stages are used for chronic lymphocytic
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leukemia:</h3><div id="CDR0000258005__31"><h4>Stage 0</h4><p id="CDR0000258005__33">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044847/" class="def">stage 0 chronic lymphocytic leukemia</a>, there are too many
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045765/" class="def">lymphocytes</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>, but there are no other signs or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045343/" class="def">leukemia</a>.
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Stage 0 chronic lymphocytic leukemia is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046355/" class="def">indolent
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</a> (slow-growing).</p></div><div id="CDR0000258005__34"><h4>Stage I</h4><p id="CDR0000258005__36">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045057/" class="def">stage I chronic lymphocytic leukemia</a>, there
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are too many <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045765/" class="def">lymphocytes</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> are larger than normal. </p></div><div id="CDR0000258005__37"><h4>Stage II</h4><p id="CDR0000258005__39">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045059/" class="def">stage II chronic lymphocytic leukemia</a>, there
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are too many <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045765/" class="def">lymphocytes</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a>
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is larger than normal, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> may be larger than normal. </p></div><div id="CDR0000258005__40"><h4>Stage III</h4><p id="CDR0000258005__42">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045061/" class="def">stage III chronic lymphocytic leukemia</a>,
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there are too many <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045765/" class="def">lymphocytes</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> and there are too few <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046124/" class="def">red blood
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cells</a>. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a> may be larger than normal.</p></div><div id="CDR0000258005__43"><h4>Stage IV</h4><p id="CDR0000258005__45">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045062/" class="def">stage IV chronic lymphocytic leukemia</a>, there
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are too many <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045765/" class="def">lymphocytes</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> and too few <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045840/" class="def">platelets</a>. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a> may be larger than normal
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and there may be too few <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046124/" class="def">red blood cells</a>.</p></div></div></div><div id="CDR0000258005__46"><h2 id="_CDR0000258005__46_">Refractory Chronic Lymphocytic Leukemia</h2><p id="CDR0000258005__47"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045863/" class="def">Refractory</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044846/" class="def">chronic lymphocytic leukemia</a> is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> that does not get better with treatment.</p></div><div id="CDR0000258005__48"><h2 id="_CDR0000258005__48_">Treatment Option Overview</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258005__49">There are different types of treatment for patients with
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chronic lymphocytic leukemia. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258005__53">Five types of standard treatment are used:</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258005__82">New types of treatment are being tested in clinical trials.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258005__154">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258005__156">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258005__158">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000258005__49"><h3>There are different types of treatment for patients with
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chronic lymphocytic leukemia. </h3><p id="CDR0000258005__51">Different types of treatment are available for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044846/" class="def">chronic lymphocytic leukemia</a>.
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Some treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some are being
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tested in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. A treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve
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current treatments or obtain information on new treatments for patients with
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. When clinical trials show that a new treatment is better than the
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standard treatment, the new
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treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.</p></div><div id="CDR0000258005__53"><h3>Five types of standard treatment are used:</h3><div id="CDR0000258005__55"><h4>Watchful waiting</h4><p id="CDR0000258005__57"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045942/" class="def">Watchful waiting</a>
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is closely <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454803/" class="def">monitoring</a> a patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> without giving any treatment until <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> appear or change. This is also called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045981/" class="def">observation</a>. During this time, problems caused by the disease, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a>, are treated.</p></div><div id="CDR0000258005__58"><h4>Radiation therapy
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</h4><p id="CDR0000258005__60"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> or keep them from growing. There are two types of radiation therapy. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the cancer. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer being treated.</p></div><div id="CDR0000258005__61"><h4>Chemotherapy </h4><p id="CDR0000258005__63"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). When chemotherapy is placed directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a>, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a>, or a body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, or the drugs mainly affect cancer cells in those areas (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046559/" class="def">regional chemotherapy</a>). The way the chemotherapy is given depends on the type and stage of the cancer being treated.</p><p id="CDR0000258005__168">See <a href="http://www.cancer.gov/about-cancer/treatment/drugs/leukemia#3" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Chronic Lymphocytic Leukemia</a> for more information.</p></div><div id="CDR0000258005__73"><h4>Surgery </h4><p id="CDR0000258005__75">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046594/" class="def">Splenectomy</a> is surgery to remove the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a>.</p></div><div id="CDR0000258005__70"><h4>Targeted therapy</h4><p id="CDR0000258005__164"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">Monoclonal antibody</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">tyrosine kinase inhibitor</a> therapy are types of targeted therapy used in the treatment of chronic lymphocytic leukemia. </p><p id="CDR0000258005__72"> Monoclonal antibody therapy is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> made in the laboratory from a single type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> cell. These antibodies can identify substances on cancer cells or normal substances in the body that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infusion</a>. They may be used alone or to carry drugs, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046622/" class="def">toxins</a>, or radioactive material directly to cancer cells.</p><p id="CDR0000258005__171">Tyrosine kinase inhibitor therapy is a cancer treatment that blocks signals needed for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> to grow.</p><p id="CDR0000258005__169">See <a href="http://www.cancer.gov/about-cancer/treatment/drugs/leukemia#3" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Chronic Lymphocytic Leukemia</a> for more information.</p></div></div><div id="CDR0000258005__82"><h3>New types of treatment are being tested in clinical trials.
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</h3><p id="CDR0000258005__151">This summary section describes treatments that are being studied in
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clinical trials. It may not mention every new treatment being studied.
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Information about clinical trials is available from the
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<a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI Web site</a>.</p><div id="CDR0000258005__121"><h4>Chemotherapy with stem cell transplant</h4><p id="CDR0000258005__123">Chemotherapy with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">stem cell transplant</a> is a method of giving chemotherapy and replacing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>-forming cells destroyed by the cancer treatment. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046598/" class="def">Stem cells</a> (immature blood cells) are removed from the blood or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045622/" class="def">bone marrow</a> of the patient or a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000643010/" class="def">donor</a> and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body’s blood cells.
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</p></div><div id="CDR0000258005__165"><h4>Biologic therapy</h4><p id="CDR0000258005__167"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">Biologic therapy</a> is a treatment that uses the patient's <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.</p></div></div><div id="CDR0000258005__154"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000258005__154_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000258005__154_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000258005__154_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000258005__156"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000258005__156_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurring</a> (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000258005__156_30">Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044267/" class="def">NCI's</a> listing of clinical trials. </p></div><div id="CDR0000258005__158"><h3>Follow-up tests may be needed.</h3><p id="CDR0000258005__158_33">Some of the tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> the cancer or to find out the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000258005__158_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> has changed or if the cancer has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back). These tests are sometimes called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044671/" class="def">follow-up</a> tests or check-ups.</p></div></div><div id="CDR0000258005__86"><h2 id="_CDR0000258005__86_">Treatment Options by Stage </h2><div id="CDR0000258005__87"><h3>Stage 0 Chronic Lymphocytic Leukemia </h3><p id="CDR0000258005__88">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044847/" class="def">stage 0 chronic lymphocytic leukemia</a> is usually <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045942/" class="def">watchful waiting</a>.</p><p id="CDR0000258005__TrialSearch_87_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=37766&tt=1&format=1&cn=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage 0 chronic lymphocytic leukemia</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000258005__95"><h3>Stage I, Stage II, Stage III, and Stage IV Chronic Lymphocytic Leukemia</h3><p id="CDR0000258005__96">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045057/" class="def">stage I</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045059/" class="def">stage II</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045061/" class="def">stage III</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045062/" class="def">stage IV chronic lymphocytic leukemia</a> may include the following:</p><ul id="CDR0000258005__97"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045942/" class="def">Watchful waiting</a> when there are few or no <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">monoclonal antibody</a> or a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">tyrosine kinase inhibitor</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> with 1 or more <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a>, with or
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without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046601/" class="def">steroids</a> or monoclonal antibody therapy. </div></li><li class="half_rhythm"><div>Low-<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">external radiation therapy</a> to areas of the body where <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is found, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of chemotherapy and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">biologic therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">stem cell
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transplant</a>.</div></li><li class="half_rhythm"><div>A clinical trial of biologic therapy. </div></li></ul><p id="CDR0000258005__TrialSearch_95_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38467&tt=1&format=1&cn=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage I chronic lymphocytic leukemia</a>, <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38479&tt=1&format=1&cn=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage II chronic lymphocytic leukemia</a>, <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38490&tt=1&format=1&cn=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage III chronic lymphocytic leukemia</a> and <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38501&tt=1&format=1&cn=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage IV chronic lymphocytic leukemia</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div></div><div id="CDR0000258005__107"><h2 id="_CDR0000258005__107_">Treatment Options for Refractory Chronic Lymphocytic
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Leukemia</h2><p id="CDR0000258005__108">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045863/" class="def">refractory</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044846/" class="def">chronic lymphocytic leukemia</a> may include the following:</p><ul id="CDR0000258005__109"><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">stem cell transplant</a>.</div></li><li class="half_rhythm"><div>A clinical trial of a new treatment.</div></li></ul><p id="CDR0000258005__TrialSearch_107_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38728&tt=1&format=1&cn=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">refractory chronic lymphocytic leukemia</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000258005__145"><h2 id="_CDR0000258005__145_">To Learn More About Chronic Lymphocytic
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Leukemia</h2><p id="CDR0000258005__146">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about chronic lymphocytic leukemia, see the following: </p><ul id="CDR0000258005__170"><li class="half_rhythm"><div><a href="http://www.cancer.gov/types/leukemia" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Leukemia Home Page</a>
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</div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/wyntk-leukemia" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">What You Need to Know About™ Leukemia
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</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/treatment/drugs/leukemia#3" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Chronic Lymphocytic Leukemia</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/treatment/types/targeted-therapies/targeted-therapies-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Targeted Cancer Therapies</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/treatment/types/immunotherapy/bio-therapies-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Biological Therapies for Cancer</a></div></li></ul><p id="CDR0000258005__145_40">For general <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information and other resources from the National Cancer Institute, see the following:</p><ul id="CDR0000258005__145_41"><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/diagnosis-staging/staging/staging-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Staging</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a></div></li><li class="half_rhythm"><div><a href="http://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors and Caregivers</a>
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</div></li></ul></div><div id="CDR0000258005__142"><h2 id="_CDR0000258005__142_">Changes to This Summary (12/30/2014)</h2><p id="CDR0000258005__143">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.</p><p id="CDR0000258005__163">Editorial changes were made to this summary.</p></div><div id="CDR0000258005__AboutThis_1"><h2 id="_CDR0000258005__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000258005__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000258005__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="http://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000258005__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000258005__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000258005__AboutThis_6">This PDQ cancer information summary has current information about the treatment of chronic lymphocytic leukemia. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000258005__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000258005__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
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</p><p id="CDR0000258005__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000258005__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000258005__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000258005__AboutThis_12">Clinical trials are listed in PDQ and can be found online at <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000258005__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000258005__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000258005__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000258005__AboutThis_21">National Cancer Institute: PDQ® Chronic Lymphocytic Leukemia Treatment. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: <a href="http://www.cancer.gov/types/leukemia/patient/cll-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www.cancer.gov/types/leukemia/patient/cll-treatment-pdq</a>. Accessed <MM/DD/YYYY>.</p><p id="CDR0000258005__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="http://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 2,000 scientific images.
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</p></div><div id="CDR0000258005__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000258005__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="http://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000258005__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000258005__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="http://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="http://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div><div id="CDR0000258005__GetMore_3"><h2 id="_CDR0000258005__GetMore_3_">Get More Information From NCI</h2><p id="CDR0000258005__GetMore_15"><i><b>Call 1-800-4-CANCER</b></i></p><p id="CDR0000258005__GetMore_16">For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.</p><p id="CDR0000258005__GetMore_25"><i><b>Chat online
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</b></i></p><p id="CDR0000258005__GetMore_26">The <a href="https://livehelp.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's LiveHelp®</a> online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI websites and answer questions about cancer.
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</p><p id="CDR0000258005__GetMore_27"><i><b>Write to us</b></i></p><p id="CDR0000258005__GetMore_28">For more information from the NCI, please write to this address:</p><ul id="CDR0000258005__GetMore_29" class="simple-list"><li class="half_rhythm"><div>NCI Public Inquiries Office</div></li><li class="half_rhythm"><div>9609 Medical Center Dr. </div></li><li class="half_rhythm"><div>Room 2E532 MSC 9760</div></li><li class="half_rhythm"><div>Bethesda, MD 20892-9760</div></li></ul><p id="CDR0000258005__GetMore_17"><i><b>Search the NCI websites</b></i></p><p id="CDR0000258005__GetMore_18">The <a href="http://www.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a> provides online access to information on cancer, clinical trials, and other websites and organizations that offer support and resources for cancer patients and their families. For a quick search, use the search box in the upper right corner of each web page. The results for a wide range of search terms will include a list of "Best Bets," editorially chosen web pages that are most closely related to the search term entered.</p><p id="CDR0000258005__GetMore_30">There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.</p><p id="CDR0000258005__GetMore_19"><i><b>Find Publications</b></i></p><p id="CDR0000258005__GetMore_20">The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the <a href="https://pubs.cancer.gov/ncipl" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI Publications Locator</a>. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237).</p></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK66050.1/?report=reader">PubReader</a></li><li><a href="/books/NBK66050.1/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK66050" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK66050" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Chronic Lymphocytic Leukemia Treatment (PDQ®): Patient Version. 2014 Dec 30. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK66050.18/">NBK66050.18</a></span> October 15, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK66050.17/">NBK66050.17</a></span> January 19, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK66050.16/">NBK66050.16</a></span> August 26, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK66050.15/">NBK66050.15</a></span> March 4, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK66050.14/">NBK66050.14</a></span> September 20, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK66050.13/">NBK66050.13</a></span> November 25, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK66050.12/">NBK66050.12</a></span> September 1, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK66050.11/">NBK66050.11</a></span> December 6, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK66050.10/">NBK66050.10</a></span> November 8, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK66050.9/">NBK66050.9</a></span> July 23, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK66050.8/">NBK66050.8</a></span> January 22, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK66050.7/">NBK66050.7</a></span> May 18, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66050.6/">NBK66050.6</a></span> March 28, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66050.5/">NBK66050.5</a></span> October 26, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK66050.4/">NBK66050.4</a></span> July 28, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK66050.3/">NBK66050.3</a></span> July 14, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK66050.2/">NBK66050.2</a></span> October 23, 2015</li><li><span class="bk_col_itm">NBK66050.1</span> December 30, 2014 (Displayed Version)</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000258005__1" ref="log$=inpage&link_id=inpage">General Information About Chronic Lymphocytic Leukemia</a></li><li><a href="#CDR0000258005__24" ref="log$=inpage&link_id=inpage">Stages of Chronic Lymphocytic Leukemia</a></li><li><a href="#CDR0000258005__46" ref="log$=inpage&link_id=inpage">Refractory Chronic Lymphocytic Leukemia</a></li><li><a href="#CDR0000258005__48" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000258005__86" ref="log$=inpage&link_id=inpage">Treatment Options by Stage </a></li><li><a href="#CDR0000258005__107" ref="log$=inpage&link_id=inpage">Treatment Options for Refractory Chronic Lymphocytic
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Leukemia</a></li><li><a href="#CDR0000258005__145" ref="log$=inpage&link_id=inpage">To Learn More About Chronic Lymphocytic
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Leukemia</a></li><li><a href="#CDR0000258005__142" ref="log$=inpage&link_id=inpage">Changes to This Summary (12/30/2014)</a></li><li><a href="#CDR0000258005__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li><li><a href="#CDR0000258005__GetMore_3" ref="log$=inpage&link_id=inpage">Get More Information From NCI</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK66035/">Health Professional Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389183" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Chronic Myelogenous Leukemia Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Chronic Myelogenous Leukemia Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389248" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Hairy Cell Leukemia Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Hairy Cell Leukemia Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em 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