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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Chronic Lymphocytic Leukemia Be Treated?

My fiancé was diagnosed with CLL about 3 1/2 years ago. He has been seen by an oncologist every 6 months since then. His white blood cell count has been going up. Every appt they kept saying that they would continue monitoring him. That if he started having symptoms that there were treatments and that it usually progresses slowly and you usually die with it rather than from it. On 3/7/18 his oncologist found that his white blood cells had jumped up a great deal. When we went in for an appointment his oncologist suggested chemotherapy for 6 months starting soon... scheduled for next week with chlorambucil and obinutuzumab. We are seeking a second opinion. We were in shock so did not ask enough questions to have any idea of prognosis, side effects, rate of success, etc. Does the chemo usually bring the number of white blood cells down sufficiently? Does the treatment sometimes cause death? How long does it help? Are the side effects usually mild or bad? Are there other alternative treatments? (besides the pills that you have to be on forever?) We are both scared.... Thanks.
Tue, 5 Jun 2018
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General & Family Physician,  's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

This idea is very right that CLL most of the times does not need treatment , and that treatment may shorten rather then prolonging life, however some times it needs treatment , treatment is mostly done for troublesome organ or lymph node enlargement, very quick rise in WBC is another indication for treatment though most doctors wont treat only high count. The treatment is effective in most of the cases in suppression of the count , it is usually done in cycles for few months ,but disease may reoccur. The treatment is effective. However it's not without hazards and serious bone marrow suppression and infection can occur with these drugs. So many times the treatment would be followed for prolonged course of antibiotics and surveillance for infection. So the risk of treatment is always weighted against benefits.

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How Can Chronic Lymphocytic Leukemia Be Treated?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. This idea is very right that CLL most of the times does not need treatment , and that treatment may shorten rather then prolonging life, however some times it needs treatment , treatment is mostly done for troublesome organ or lymph node enlargement, very quick rise in WBC is another indication for treatment though most doctors wont treat only high count. The treatment is effective in most of the cases in suppression of the count , it is usually done in cycles for few months ,but disease may reoccur. The treatment is effective. However it s not without hazards and serious bone marrow suppression and infection can occur with these drugs. So many times the treatment would be followed for prolonged course of antibiotics and surveillance for infection. So the risk of treatment is always weighted against benefits. Hope I have answered your query. Let me know if I can assist you further.