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Chronic Lymphocytic Leukemia (CLL)

An indolent (slow-growing) cancer in which too many immature lymphocytes (white blood cells) are found mostly in the blood and bone marrow.

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(Source: NIH - National Cancer Institute)

About Chronic Lymphocytic Leukemia (CLL)

Chronic lymphocytic leukemia is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).

Chronic lymphocytic leukemia (also called CLL) is a blood and bone marrow disease that usually gets worse slowly. CLL is one of the most common types of leukemia in adults. It often occurs during or after middle age; it rarely occurs in children.

Leukemia may affect red blood cells, white blood cells, and platelets.

Normally, the body makes blood stem cells (immature cells) that become mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell... Read more about Chronic Lymphocytic Leukemia

What works? Research summarized

Evidence reviews

Effectiveness and safety of FCR regimen for chronic lymphocytic leukemia: a systematic review

Bibliographic details: Zhao L, Xi YM, Guo M, Chao R, Jin RR.  Effectiveness and safety of FCR regimen for chronic lymphocytic leukemia: a systematic review. Chinese Journal of Evidence-Based Medicine 2011; 11(11): 1321-1326

The role of the monoclonal antibody alemtuzumab for treatment of people with chronic lymphocytic leukaemia

Chronic lymphocytic leukaemia (CLL) is a cancer and accounts for 25% of all leukaemias. The disease is the most common cancer of the lymphatic system in Western countries and is characterised by a highly variable clinical course and prognosis. Some patients may have minimal or no symptoms for many years with a normal life expectancy, without requiring treatment. Others are symptomatic at diagnosis or early thereafter and can experience infectious and autoimmune complications, leading to a reduced lifespan. Standard treatment includes chemotherapy with one or more agents. Nowadays monoclonal antibodies are added, especially alemtuzumab and rituximab. However, the impact of these agents remains unclear, as there were hints for increased overall survival, but also risk for severe infections in non‐randomised trials. In this systematic review we summarised and analysed the evidence from randomised controlled trials (RCTs) on efficacy and safety of alemtuzumab in the treatment of CLL. We searched several important medical databases such as CENTRAL, MEDLINE and EMBASE and found five RCTs fulfilling our pre‐defined inclusion criteria. We included trials that compared alemtuzumab with no further therapy or with anti‐cancer therapy in newly‐diagnosed or relapsed patients with CLL. In total, 845 patients were treated within the five trials.

Purine Antagonists for Chronic Lymphocytic Leukaemia

Despite increasing insight into its tumour biology B‐CLL remains an incurable disease. So far, chemotherapy with alkylating agents such as chlorambucil has been the mainstay of treatment in B‐CLL. However, purine antagonists such as fludarabine are increasingly being used, as it has been suggested that these novel drugs are more effective. This review confirms the greater response rates achievable by using purine antagonists but at the cost of greater toxicity, mainly infections. There is inconclusive evidence whether treatment with purine antagonists improves survival. None of the studies included quality of life data. More research is needed to fully explore the role of purine antagonists in the treatment of B‐CLL and their potential impact on survival.

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Summaries for consumers

The role of the monoclonal antibody alemtuzumab for treatment of people with chronic lymphocytic leukaemia

Chronic lymphocytic leukaemia (CLL) is a cancer and accounts for 25% of all leukaemias. The disease is the most common cancer of the lymphatic system in Western countries and is characterised by a highly variable clinical course and prognosis. Some patients may have minimal or no symptoms for many years with a normal life expectancy, without requiring treatment. Others are symptomatic at diagnosis or early thereafter and can experience infectious and autoimmune complications, leading to a reduced lifespan. Standard treatment includes chemotherapy with one or more agents. Nowadays monoclonal antibodies are added, especially alemtuzumab and rituximab. However, the impact of these agents remains unclear, as there were hints for increased overall survival, but also risk for severe infections in non‐randomised trials. In this systematic review we summarised and analysed the evidence from randomised controlled trials (RCTs) on efficacy and safety of alemtuzumab in the treatment of CLL. We searched several important medical databases such as CENTRAL, MEDLINE and EMBASE and found five RCTs fulfilling our pre‐defined inclusion criteria. We included trials that compared alemtuzumab with no further therapy or with anti‐cancer therapy in newly‐diagnosed or relapsed patients with CLL. In total, 845 patients were treated within the five trials.

Chronic Lymphocytic Leukemia Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of chronic lymphocytic leukemia.

Purine Antagonists for Chronic Lymphocytic Leukaemia

Despite increasing insight into its tumour biology B‐CLL remains an incurable disease. So far, chemotherapy with alkylating agents such as chlorambucil has been the mainstay of treatment in B‐CLL. However, purine antagonists such as fludarabine are increasingly being used, as it has been suggested that these novel drugs are more effective. This review confirms the greater response rates achievable by using purine antagonists but at the cost of greater toxicity, mainly infections. There is inconclusive evidence whether treatment with purine antagonists improves survival. None of the studies included quality of life data. More research is needed to fully explore the role of purine antagonists in the treatment of B‐CLL and their potential impact on survival.

See all (24)

Terms to know

B-Lymphocytes (B-Cells)
A type of white blood cell that makes antibodies. B lymphocytes are part of the immune system and develop from stem cells in the bone marrow. Also called B cell.
Blood
A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
Bone Marrow
The soft, sponge-like tissue in the center of most bones. It produces white blood cells, red blood cells, and platelets.
Chronic
Refers to disorders that last a long time, often years. Chronic is the opposite of acute, or brief.
Leukemia
Cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of blood cells to be produced and enter the bloodstream.
Lymphocytes
A lymphocyte is a type of white blood cell that is part of the immune system. There are two main types of lymphocytes: B cells and T cells. The B cells produce antibodies that are used to attack invading bacteria, viruses, and toxins. The T cells destroy the body's own cells that have themselves been taken over by viruses or become cancerous.
Lymphoid
Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop.
Myeloid
Having to do with or resembling the bone marrow. May also refer to certain types of hematopoietic (blood-forming) cells found in the bone marrow. Sometimes used as a synonym for myelogenous; for example, acute myeloid leukemia and acute myelogenous leukemia are the same disease.

More about Chronic Lymphocytic Leukemia

Photo of an adult

Also called: B-cell chronic lymphocytic leukaemia/small lymphocytic lymphoma, Chronic lymphatic leukaemia, Chronic lymphocytic leukaemia, Chronic lymphoid leukaemia, B-cell chronic lymphocytic leukaemia, B-cell chronic lymphocytic leukemia, B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma, Chronic lymphatic leukemia, Chronic lymphoid leukemia, B-CLL

Other terms to know: See all 8
B-Lymphocytes (B-Cells), Blood, Bone Marrow

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