New Treatments to Stop Chronic Lymphocytic Leukemia From Progressing

Medically Reviewed By William C. Lloyd III, MD, FACS
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Your bone marrow produces blood cells: white blood cells to help fight infection, red blood cells to transport oxygen, and platelets to form clots and stop bleeding. But if you have a form of cancer known as chronic lymphocytic leukemia (CLL), a type of white blood cell called a lymphocyte grows abnormally and begins to build up in your bone marrow, crowding out the healthy cells. This impacts your bone marrow’s ability to make normal blood cells. Eventually, the cancer cells can move from your bone marrow into your blood and travel to other parts of your body, including your lymph nodes, spleen, and liver.

CLL is the most common form of leukemia in adults. Thankfully, in recent years, major advancements have been made in treating this type of leukemia and slowing its progression.

Chronic Lymphocytic Leukemia Treatment Considerations

Before discussing some of the new treatments for CLL, it’s helpful to understand what information your doctor uses to select the appropriate treatment plan for you. Your cancer will be given a stage to indicate how advanced it is. This takes into account whether the leukemia cells have spread to your lymph nodes and other organs and whether your blood cell counts are abnormal. Early-stage CLL may not need to be treated, taking a “watch and wait” approach instead, while later-stage cases will need treatment. Your doctor will also consider your age, your overall health, and whether you’ve had previous leukemia treatments.

Researchers are learning more and more about what happens within the cancer cells and what genetic changes cause them to grow abnormally. Experts are also learning that not all CLL cases are the same, so your doctor may run tests to determine what “type” of CLL you have. Identifying specific proteins or alterations in the genes of your cancer cells can be extremely useful when choosing a new leukemia treatment.

New and Emerging Chronic Lymphocytic Leukemia Treatments

Patients with CLL may still be treated with standard cancer treatments like chemotherapy and radiation, but the addition of new targeted therapies has shown promising results. As the name implies, targeted therapies “target” certain genes or proteins that help cancer cells grow. The goal of targeted therapy is to kill cancer cells while leaving normal cells unharmed. A few different kinds are used to treat CLL, including:

  • Monoclonal antibodies: Researchers have developed man-made antibodies that attach to the leukemia cell and help your immune system destroy it. Rituximab (Rituxan), in conjunction with chemotherapy, has been used as a common treatment for CLL for several years. Other monoclonal antibodies include obinutuzumab (Gazya) and ofataumumab (Arzerra). They are administered as infusions into a vein.

  • Kinase inhibitors: Kinases are a type of protein found in cells that give those cells a signal to grow. Drugs have been developed to block certain kinases in leukemia cells, thereby impacting their ability to survive. Ibrutinib (Imbruvica) is an example. It was the first FDA-approved drug for CLL that could be given as a standalone treatment without chemotherapy. Idelalisib (Zydelig) and duvelisib (Copiktra) are also kinase inhibitors. They’re given as an oral pill.

  • BCL2 inhibitor: BCL2 is a protein found in some leukemia cells that help them live longer. Venetoclax (Venclexta) is a daily pill that blocks BCL2 and can help eliminate cancer cells.

In addition to discovering new leukemia treatments, researchers are also studying different ways to combine them. For example, a recent study suggests that combining venetoclax and rituximab lowered the risk of CLL progression by more than 80% as compared to standard chemotherapy. Researchers aim to find the most effective treatment combinations while also lowering the risk for developing dangerous side effects.

Other areas being studied for future CLL treatments include:

  • Vaccines: Vaccines are being developed to help boost your immune system to kill the cancer cells.

  • Chemotherapy and stem cell transplant: Before chemotherapy, immature blood cells called stem cells are taken from your body and stored. After chemotherapy is complete, the stem cells are given back through an infusion to help restore your blood cells.

  • Chimeric antigen receptor (CAR) T-cell therapy: This treatment takes cells from your immune system and changes them in a laboratory by adding a special receptor to them. They are then infused back into your blood, specially designed to attack the cancer cells.

Even with so many advancements in treating chronic lymphocytic leukemia, we can expect that more will be coming in the future. Ask your doctor if you’re interested in learning more about slowing the progression of your cancer. Clinical trials are also a great way to get access to some of the newest and cutting-edge CLL treatments.

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  1. Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma: FDA Updates. Lymphoma Research Foundation. https://www.lymphoma.org/aboutlymphoma/cll/cllfdaupdates/
  2. Drug Combination Improves Outlook for Some Patients with Chronic Lymphocytic Leukemia. National Cancer Institute. https://www.cancer.gov/news-events/cancer-currents-blog/2018/venetoclax-rituximab-cll
  3. Leukemia: Chronic Lymphocytic Leukemia. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/6210-leukemia-chronic-lymphocytic-leukemia
  4. Leukemia - Chronic Lymphocytic - CLL: Types of Treatment. American Society of Clinical Oncology. https://www.cancer.net/cancer-types/leukemia-chronic-lymphocytic-cll/types-treatment
  5. Targeted Therapy for Chronic Lymphocytic Leukemia. American Cancer Society. https://www.cancer.org/cancer/chronic-lymphocytic-leukemia/treating/targeted-therapy.html
  6. What's New in Chronic Lymphocytic Leukemia Research and Treatment? American Cancer Society. https://www.cancer.org/cancer/chronic-lymphocytic-leukemia/about/new-research.html
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 29
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