NCCN Guidelines for Patients® | Chronic Lymphocytic Leukemia

22 NCCN Guidelines for Patients ® : Chronic Lymphocytic Leukemia, 2019 3  Treatment guide Overview This chapter presents the treatment options for CLL. It also reviews some key parts of supportive care. Discuss with your doctor which options are right for you. Overview Treatment of CLL includes treatment of the cancer and support for you. At this time, CLL is rarely cured. Instead, the aim of treatment is to reduce symptoms, control the cancer, and extend life. Del(17p)/ TP53 mutation Treatment options depend on many factors. One main factor is whether there are missing parts of chromosome 17 called “del(17p).” Del(17p) is linked with loss of the TP53 gene. In this chapter, treatment options are listed by whether del(17p) or the TP53 mutation is present. Treatment results During and at the end of treatment, you will recieve tests to assess the results. These tests include physical exams and blood tests. There are four types of treatment response: † † Complete remission is the best outcome. Enlarged organs and lymph nodes are back to normal size. Blood counts are within normal range. You have no cancer symptoms like fever. † † Partial remission is a good response. The size of enlarged organs and nodes has been greatly reduced. Blood counts are returning to normal. † † Stable disease is less than a partial remission. The cancer is not getting worse. † † Progressive disease is a worsening of the cancer. If remission is achieved, your doctor may give you maintenance treatment. At this time, it is not used often for CLL. The goal is to maintain the good results of prior treatment. Relapsed or refractory CLL A relapse is the return of cancer after it’s been in remission for more than 6 months. You may not need treatment right away. When treatment is needed, your doctor may give the same or a different type of treatment than was given before. The goal of treatment is to achieve remission again. Refractory disease is cancer that is not in remission at the end of treatment. It also includes progressive disease within 6 months after treatment has ended. In these cases, a different treatment may be tried. Good results are often achieved with a different treatment. Supportive care Supportive care aims to improve your quality of life. It includes care for health issues caused by cancer or cancer treatment. It is a key part of treatment for everyone, not just people at the end of life. Talk with your treatment team to get the best supportive care for you.