DEAR MAYO CLINIC: Are there any new treatment options for chronic lymphocytic leukemia? I am 61 and was diagnosed 18 months ago. Until recently, I have not had any symptoms so have not received treatment for it.
ANSWER: Researchers are currently studying a variety of potential new treatments for chronic lymphocytic leukemia, or CLL. Many of them are available now through clinical trials. Depending on your situation, you may be eligible to participate in a clinical trial and receive one of the new therapies.
CLL is a cancer of the blood and the spongy tissue inside bones where blood cells are made, called bone marrow. In particular, this disease affects a group of white blood cells called lymphocytes that help your body fight infection.
CLL usually progresses slowly. As in your situation, many people in the early stages of CLL do not have any symptoms. When symptoms start to develop, they may include enlarged lymph nodes, pain in the upper left abdomen, fatigue, fever, night sweats, weight loss and frequent infections.
People with early-stage chronic lymphocytic leukemia typically do not receive treatment. At that stage of the disease, the risks associated with possible side effects and complications from treatment usually outweigh the benefits you would receive from it. Instead, doctors carefully monitor the condition, a process known as watchful waiting, and often hold off on treatment until the disease progresses. Watchful waiting usually involves a schedule of regular check-ups and blood tests every few months.
At this time, though, clinical trials are investigating whether treatment can help bolster a person's immune system when they are in the early stages of CLL and do not show any symptoms. The trials also are assessing whether an improvement in the immune system may help slow the progression of CLL in those people.
The purpose of clinical trials is to learn if a new test or treatment works and is safe. Treatments studied in clinical trials can be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. People who participate in these trials are volunteers. During clinical trials, researchers are trying to gather new knowledge that will help them improve medical care for people in the future.
Not all health care organizations offer clinical trials to their patients, but most large academic medical centers have them available on a regular basis. Many clinical trials that study different kinds of cancer often are underway at the same time.
For example, Mayo Clinic is currently seeking volunteers for a number of clinical trials involving CLL treatment. Whether you would be able to participate depends on the specific stage of your disease. Your medical history, family history and other medical conditions you may have, along with additional factors specific to each clinical trial also would be carefully considered to decide on your eligibility for that trial.
If you are interested in exploring the options available for CLL clinical trials, ask your doctor if your health care facility has any available, or if it works with another health care provider to connect patients to current clinical trials. If it does not, you may consider looking into the possibility of a clinical trial at an academic medical center. For information about the clinical trials offered through Mayo Clinic, you can visit the website www.mayoclinic.org. You will find details under the “Research” tab at “Find Clinical Trials.” — Asher Chanan-Khan, M.D., Hematology, Mayo Clinic, Jacksonville, Fla.