Early stage disease often requires no specific treatment, but it is important to be closely monitored by your doctor.

Chemotherapy may be needed if fatigue, anemia, thrombocytopenia, recurrent infections, or lymph node swelling occurs. Several chemotherapy drugs are commonly used to treat CLL. Fludarabine, chlorambucil, cyclophosphamide (Cytoxan), and rituximab (Rituxan) may be used.

Alemtuzumab (Campath) is approved for treatment of patients with CLL that has not responded to fludarabine. Bendamustine is a newer drug recently approved for use in patients with CLL that has come back after initial treatment.

Rarely, radiation may be used for enlarged lymph nodes. Blood transfusions or platelet transfusions may be required. Bone marrow or stem cell transplantation may be used in younger patients with advanced CLL. Right now, transplant is the only therapy that offers a potential cure for CLL.

The outlook depends on the stage and behavior of the disease. Half of patients diagnosed in the earliest stages of the disease live more than 12 years. Some people may not require any treatment at all, while others may have faster spreading disease that requires therapy.

Newer tests that look at cell and genetic changes may be done.

• Autoimmune hemolytic anemia
• Bleeding from low platelets
• Fatigue from anemia
• Hypogammaglobulinemia (reduced levels of antibodies) -- increases the risk of infection
• Idiopathic thrombocytopenic purpura (ITP)
• Other cancers
• Side effects of chemotherapy

Call health care provider if you develop enlarged lymph nodes or unexplained fatigue, bruising, excessive sweating, or weight loss.