Chronic lymphocytic leukemia: should we even treat?
Unlike other types of leukemia, chronic lymphocytic leukemia can remain without symptoms for years, and in such cases we don’t even have to treat patients. For this reason, we can say that chronic lymphocytic leukemia is the best leukemia to get. Its life expectancy exceeds its siblings and it rarely shows symptoms except late in the disease. What is even better is that the vast majority of patients are more than 60 years old. The only way chronic lymphocytic leukemia is treated is through stem cell transplantation. Nucleoside analogues include fludarabine, cladribine and pentostatin are the cornerstone of chemotherapy treatment of CLL. The gold standard in the treatment of chronic lymphocytic leukemia is fludarabine, and the most commonly used combination is fludarabine plus cyclophosphamide and rituximab.
Read also; How Long Can You Live with Chronic Lymphocytic Leukemia?
Other newer options include biologic agents, which target cancer cells more specifically than chemotherapy. But none of the previous treatment is given unless there is evidence of a rapid progression of the disease to spare the patient their side effects against a disease which is rarely cured and doesn’t cause symptoms. This practice is further proven by clinical trials which showed no benefit neither in the overall quality of life nor survival if chemotherapy is introduced early in the disease, and this example demonstrates how different the concept of quality of life is from simply curing a disease.