Chemotherapy and targeted therapy for CLL

If you need treatment for chronic lymphocytic leukaemia (CLL), you will often have a combination of chemotherapy and targeted therapy drugs. Some people have targeted therapy drugs on their own.

Chemotherapy uses anti-cancer drugs called cytotoxics to kill the leukaemia cells or slow their growth. Targeted therapy drugs attack specific features of leukaemia cells to stop them growing and multiplying.

Learn more about:

• Different types of drugs for CLL
• Side effects of chemotherapy
• Taking care with infections
• Video: What is chemotherapy?

Different types of drugs for CLL

It is common to have chemotherapy and targeted therapy drugs through a drip into a vein (intravenous infusion) or as an injection. This is usually during a day visit to a treatment centre. Some drugs can be given as tablets that you take at home. What drugs you are offered will depend on the stage of the CLL, the results of genetic tests, and your age, health and personal preferences.

• If the CLL has no high-risk chromosomal abnormalities and you are fit and healthy – it is common to have a treatment called FCR, a combination of the chemotherapy drugs fludarabine and cyclophosphamide and the targeted therapy drug rituximab. The drugs are usually given over four days, followed by a rest period of a few weeks. This cycle is repeated up to six times.

• If you are older or have other medical issues – the FCR combination may cause too many side effects so you may be offered a less intense treatment plan. This may include a combination of the targeted therapy drugs venetoclax and obinutuzumab.

• If the CLL shows genetic changes or returns after initial treatment – you may be given other targeted therapy drugs. Options may include ibrutinib, acalabrutinib, venetoclax and obinutuzumab, or idelalisib plus rituximab.

• If the CLL returns after initial treatment – you may be offered different chemotherapy and targeted therapy drugs, such as ibrutinib, acalabrutinib or venetoclax.

There is a lot of research into CLL, and new drugs are regularly becoming available. Talk to your doctor about the latest developments and if there is a suitable clinical trial you can join.

Video: What is chemotherapy?

Watch this short video to learn more about chemotherapy.