NCCN Guidelines for Patients® | Chronic Lymphocytic Leukemia

NCCN Guidelines for Patients ® : Chronic Lymphocytic Leukemia, 2018 3 Cancer treatments Chemotherapy 27 Chemotherapy Chemotherapy, or “chemo,” includes drugs that disrupt the life cycle of cancer cells so they can’t increase in number. Some chemotherapy drugs kill cancer cells by damaging their DNA or by disrupting the making of DNA. Other drugs interfere with cell parts that are needed for making new cells. Thus, no new cells are made to replace dying cells. Chemotherapy is often used to treat CLL. Many chemotherapy drugs work when cells are in an active growth phase. During the active growth phase, cells grow and divide to form a new cell. Chemotherapy drugs that disrupt the growth phase work well for cancer cells that are growing and dividing quickly. Other chemotherapy drugs work whether cells are in a growth or resting phase. Chemotherapy can kill both cancer and normal cells. Most chemotherapy drugs for CLL are liquids that are slowly injected into a vein. Some are made as pills that can be swallowed. By any method, the drugs travel in your bloodstream to treat cancer throughout your body. Doctors use the term “systemic” when talking about a cancer treatment for the whole body. Chemotherapy and other drugs used to treat CLL are listed in Guide 2 on the next page. Chemotherapy is given in cycles of treatment days followed by days of rest. This allows the body to recover before the next cycle. Cycles vary in length depending on which drugs are used. Often, one total cycle is 4 weeks long. Chemotherapy may consist of one or more drugs. When only one drug is used, it is called a single agent. However, not all drugs work the same way, so often more than one drug is used. A combination regimen is the use of two or more chemotherapy drugs. Part 4 is a guide that explains who should receive which treatments. You will learn which regimens may be part of your treatment. Chemotherapy is sometimes given in high doses and followed by a stem cell transplant. Stem cell transplants are described later in this chapter. Side effects of chemotherapy Side effects of chemotherapy differ between people. Some people have many side effects. Others have few. Some side effects can be very serious while others can be unpleasant but not serious. Most side effects appear shortly after treatment starts and will stop after treatment. However, other side effects are long-term or may appear years later. Side effects of chemotherapy depend on many factors. These factors include the drug type, amount taken, length of treatment, and the person. In general, most side effects are caused by the death of fast-growing cells. These cells are found in the blood, gut, hair follicles, and mouth. Thus, common side effects of chemotherapy include low blood cell counts, not feeling hungry, nausea, vomiting, diarrhea, hair loss, and mouth sores. Long-term side effects of chemotherapy for CLL include increased risk for getting infections. Not all side effects of chemotherapy are listed here. Please ask your treatment team for a complete list of common and rare side effects. If a side effect bothers you, tell your treatment team. There may be ways to help you feel better. There are also ways to prevent some side effects.