Other treatments for CLL
In some cases, your doctor may recommend other ways to manage and control symptoms of chronic lymphocytic leukaemia (CLL) and side effects of treatment.
Learn more about these other treatments for CLL:
- Steroid therapy
- Allopurinol tablets
- Immunoglobulin infusions
- Radiation therapy
- Surgery (splenectomy)
- Stem cell transplant
- Video: What is radiation therapy?
- Video: What is surgery?
Steroids are made naturally in the body and can also be produced in a laboratory and used as drugs. Steroid therapy can help prevent or reduce some chemotherapy side effects, such as nausea. It may also be used on its own to treat CLL if you can’t have chemotherapy because your red blood cell or platelet count is too low.
If you have a very high white blood cell count, a chemical called uric acid may build up in the blood during treatment. This can cause pain and inflammation of the joints (gout), and may damage your kidneys. To prevent this, you may be given allopurinol tablets.
Immunoglobulin is an antibody that helps your body fight infections. CLL usually causes low immunoglobulin levels, so you may be given immunoglobulins through a drip to help boost your immune system if infections keep coming back or are severe.
Also known as radiotherapy, this uses a controlled dose of radiation to kill leukaemia cells or damage them so they cannot grow, multiply or spread. The radiation is usually in the form of x-ray beams. Radiation therapy is not a standard treatment for CLL, but may be used to treat a swollen spleen or swollen lymph nodes. It can also be helpful for people having palliative treatment.
For more on this, see Radiation therapy.
Occasionally, the spleen will be removed if it is very swollen and pressing on nearby organs. This treatment may be used for people who have immune thrombocytopenic purpura (ITP), an autoimmune disease that targets the platelets. Your surgeon can give you more information about this operation.
Stem cell transplant
Rarely, very high doses of chemotherapy or radiation therapy are needed to destroy the leukaemia cells. This can also damage the stem cells in the bone marrow, and a stem cell transplant is done to help restore the bone marrow and rebuild the immune system. The stem cells are usually collected from another person (allogeneic transplant).
A stem cell transplant isn’t a suitable treatment for most people with CLL. This is because the procedure is considered too risky for people with slow-growing disease.
If CLL is progressing more quickly or hasn’t responded to chemotherapy, you may be offered a reduced-intensity stem cell transplant (sometimes called a mini transplant). This means lower doses of chemotherapy and radiation therapy are used for the transplant, so it is easier for the body to tolerate.
If you are having a stem cell transplant, your medical team will explain what will happen and the possible side effects.
For more information on stem cell transplants for CLL, you can contact the Leukaemia Foundation on 1800 620 420.
Video: What is radiation therapy?
Video: What is surgery?
Download a PDF booklet on this topic.
Dr Kate Melville, Haematology Staff Specialist, Calvary Mater Newcastle, and Conjoint Lecturer, The University of Newcastle; Karl Jobburn, Clinical Nurse Consultant, Haematology, Liverpool Hospital; Patricia Masters, Consumer; Karen Robinson, 13 11 20 Consultant, Cancer Council NSW; Dr Emma Verner, Staff Specialist, Haematology, and Medical Director, Bone Marrow Transplant and Apheresis Unit, Concord Hospital, and Clinical Senior Lecturer, The University of Sydney.
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