NCCN Guidelines for Patients® | Chronic Lymphocytic Leukemia
29 NCCN Guidelines for Patients ® : Chronic Lymphocytic Leukemia, 2018 3 Cancer treatments Steroids | Immunomodulators Steroids Steroids are a type of drug that is often used to relieve inflammation. Steroids can also have anti- cancer effects. Methylprednisolone is a corticosteroid used to treat CLL. Read Part 4 for more information on when it’s used. Methylprednisolone is given in high doses along with rituximab. Rituximab is described in the Targeted therapy section in this chapter. Methylprednisolone can either be injected into your vein or swallowed in pill form. It is often taken for a few days during a 1-month cycle. Prednisone is another steroid that is used to treat CLL. It is given along with some chemotherapy regimens. Prednisone is made in pill form and is taken once a day with food. Most side effects of steroids fade away once the drugs are stopped. Common side effects include feeling hungry, trouble sleeping, slow wound healing, upset stomach, and swelling in the ankles, feet, and hands. Methylprednisolone with rituximab increases the likelihood of getting infections. Immunomodulators The immune system is your body’s natural defense against illness. Immunomodulators are drugs that modify different parts of the immune system. Lenalidomide is an immunomodulator used to treat CLL. Lenalidomide is made in pill form. It is given in cycles of treatment days followed by days of rest. A cycle may consist of 3 weeks of treatment and 1 week of rest. It may also be given for 4 straight weeks. Cycles may repeat until the cancer grows or side effects become severe. Lenalidomide treats cancer in more than one way. As an immunomodulator, it boosts the immune system. It also helps stop cancer cells from increasing in number. Third, it also works like a type of targeted therapy called angiogenesis inhibitors. These drugs stop the growth of new blood vessels that would provide food (nutrients) to the cancer. Common side effects include low blood counts, diarrhea, itching, rash, and fatigue. Serious but less common side effects include blood clots, bleeding disorders, loss of vision, and skin cancer. Ask your treatment team for a full list of side effects.