Chronic Lymphocytic Leukemia Treatment and Survival Rate

April 19, 2024 
This page was reviewed under our medical and editorial policy by Guido Marcucci, M.D., Chair, Department of Hematologic Malignancies Translational Science, City of Hope Duarte

Chronic lymphocytic leukemia, or CLL, is a cancer of the blood and bone marrow. A number of treatment options are available for this disease, and CLL treatment is customized to each patient. Each treatment plan takes into account the patient’s overall health, the CLL type and subtype, and personal preferences.

This guide to CLL treatments and survival rates is designed to help patients and their families understand more about their options.

CLL Treatment Options

CLL is often a cancer that grows slowly, and it may be several years before symptoms appear or treatment is needed. Some patients may never require treatment, but each CLL case is unique.

The most common CLL treatment options are listed below.

Active surveillance: Also called watchful waiting, this is the standard treatment for CLL patients in the early stage who don’t have symptoms.

During active surveillance, patients are closely monitored through blood tests and physical exams. If doctors notice that CLL is increasing in severity, active treatment may begin.

Chemotherapy: Chemotherapy uses medication to destroy cancer cells. One or several chemotherapy drugs may be administered, either orally or by injection.

Chimeric antigen receptor (CAR) T cell therapy: CAR T cell therapy is a type of immunotherapy that allows the care team to collect the patient's own T cells and modify them. Those cells are then reintroduced into the patient's body so they can target and destroy cancer cells. The U.S. Food and Drug Administration approved the first CAR T cell therapy treatment for CLL in 2024.

Radiation therapy: Radiation therapy uses high-energy X-rays or other types of radiation to destroy cancer cells. While it is not a common treatment for CLL, it may be used to manage symptoms if cancer has spread to the lymph nodes or spleen.

Stem cell transplantation: A stem cell transplant is usually combined with chemotherapy. After a high dose of chemotherapy, stem cells in the patient’s blood or bone marrow are replaced with healthy cells. Stem cells may come from the patient (autologous) or from a matched donor (allogeneic). Sometimes, the cells come from a newborn’s umbilical cord blood.

Surgery: If cancer has spread into the spleen, it might be surgically removed. This procedure is called a splenectomy.

Targeted therapy: This treatment uses medication to identify cancer cells and destroy them by targeting their genes or proteins, while minimizing damage to the healthy cells nearby.

Clinical trials: Some patients may qualify for clinical trials, an opportunity to participate in tests of innovative treatments while receiving the highest standard of care.

When treating CLL, it may not be possible to remove all cancer cells from the body, but doctors focus on reducing symptoms and working toward long-term remission.

Each patient’s health care team will explain what to expect from treatment, monitoring and follow-up care.

CLL Survival Rate

Survival rates are estimates of the percentage of patients who are alive five years or more after their initial diagnosis, compared to people who don’t have that cancer type. For CLL, the five-year relative survival rate is 89.3%, according to the National Cancer Institute.

Treatment options for CLL are always improving, leading to an increase in survival rates over time. Because each person’s cancer is unique, questions about possible health outcomes may be answered by his or her care team.