Our Treatment Approach
The Center for Chronic Lymphocytic Leukemia is part of Dana-Farber Brigham Cancer Center's Center for Hematologic Oncology, one of the world's largest and most respected treatment centers for patients with disorders of the blood or bone marrow.
Your care will involve the best treatments currently available, and may include therapies based on the discoveries made in our own laboratories or elsewhere in the field of CLL research. We carefully consider an array of clinical trials — the mainstay of our treatment approach — some of which are only available here and have been developed by our physician-scientists.
Your care is coordinated by a world-class team of specialists — including medical oncologists, hematopathologists, lab scientists, nursing professionals, physician assistants, psychologists, clinical car coordinators, social workers, and nutritionists — with years of expertise in treating patients with CLL.
Our providers work together to coordinate fully integrated, personalized care, from your initial diagnosis through treatment at each stage, to try to keep ahead of the disease and offer the best possible outcomes.
As a highly specialized Center within Dana-Farber Brigham Cancer Center's Center for Hematologic Oncology, the Center for Chronic Lymphocytic Leukemia focuses on the distinct needs of people with CLL. This enables us to provide a highly personalized approach to your care. In order to create the most effective treatment plan, your care team will adjust your therapy based on how you respond to a particular treatment.
We take time to involve you and your family in each step of the treatment process. As you go through treatment phases, you and your family will have access to a wide range of support resources — from nutrition services to integrative therapies.
For older patients, our team partners with a geriatrician to help manage CLL treatment alongside other health conditions that a patient may have.
Treatment Options for Chronic Lymphocytic Leukemia
Each patient's care involves careful consideration of the timing of treatment, standard therapies, novel drug combinations, and new therapies. As resistance arises, we re-evaluate our approach and shift treatment strategies as needed.
Treatment plans depend on:
- The prognostic markers of the disease.
- The stage of the disease.
- Red blood cell, white blood cell, and platelet blood counts.
- Whether there are signs or symptoms.
- Whether the liver, spleen, or lymph nodes are larger than normal.
- The response to initial treatment.
- Whether the CLL has recurred (come back).
While treatment for CLL is usually not curative, most people live for many years with this disease. For many patients with early-stage CLL, immediate treatment is not necessary, though treatment will likely be needed when the disease progresses.
Treatments can include:
Patients who are not experiencing symptoms or who have a precursor condition may not need immediate treatment and can be monitored for disease progression. Research shows that it is not beneficial to start treatment right away in patients without symptoms, anemia, or thrombocytopenia. This is especially true since newer, more effective, or better tolerated drugs are continuously becoming available or accessible as first-line treatment.
For patients who require treatment, most patients are treated with targeted drug therapy. When treatment is needed, you may need a CT scan and/or a bone marrow biopsy.
Targeted therapies are drugs that identify and attack specific cancer cells more than normal cells.
Monoclonal antibody therapy is a kind of targeted therapy treatment that uses antibodies made in the lab from a single type of immune system cell. These antibodies can identify molecules on cancer cells or normal substances in the body that may help cancer cells grow. A few examples of such antibodies are rituximab, and obinutuzumab.
Several oral targeted agents have also recently been approved for treatment of CLL. These include ibrutinib, idelalisib, venetoclax, acalabrutinib, and duvelisib.
View videos of our experts speaking about various CLL treatments:
Cellular Therapies: Stem Cell/Bone Marrow Transplant
We work closely with our hematopoietic Stem Cell Transplantation Program when CLL patients require bone marrow/stem cell transplant, usually in later stages of treatment. Our Stem Cell Transplantation Program is one of the largest and most experienced in the world.