What is the treatment depends on the stage of the disease. For up to 20 years, the course of the disease can be benign. This means that apart from fatigue, loss of appetite and enlarged lymph nodes, there are no symptoms.
The actual therapy begins when the lymphocytes are elevated or the platelets and red blood cells are decreased. Other complications may also be crucial. The success rate is not influenced by the (early) start of treatment.
In the case of rapidly developing CLL or certain risk factors that would negatively influence the course, treatment may be necessary very quickly.
This is the most important treatment for CLL and can be given with tablets and/or infusions. The treatment success is initially usually very good, symptoms can be kept at bay for years. Rarely, additional radiation therapy is necessary.
Monoclonal antibodies (e.g. alemtuzumab, rituximab) are a more modern therapeutic approach. They bind to proteins that are often found on the surface of leukocytes and destroy them.
Symptomatic treatment serves as an adjunct to chemotherapy. Transfusions help against anaemia, antibiotics against infections. Immunodeficiencies are compensated with antibodies, other disorders of the immune system with cortisone. If individual lymph nodes cause discomfort due to swelling, local radiation can provide relief.
Bone marrow and stem cell transplantation
Young patients (<60 yrs) may receive a stem cell (SCT) or bone marrow transplant (BMT). Stem cells are a type of blueprint for blood cells that are stored in the bone marrow until further development.
A high success rate has so far been shown with autologous SZT. In this case, special stem cells that have already been harvested and purified are transferred to the patient directly after high-dose chemotherapy.