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Chronic Lymphocytic Leukemia: Treatment, Procedure, Cost and Side Effects

Last Updated: Apr 25, 2024

What is the treatment?

N/A

How is the treatment done?

Chronic lymphocytic leukemia is a cancer that affects the blood and bone marrow which is the spongy tissue present inside the bones. Blood cells are produced in this spongy tissue. This condition is referred to as chronic as it progresses in a much slower manner when compared to other forms of cancer. A group of white blood cells called lymphocytes, which help the body to fight infection, are affected by this disease. Mostly, older adults are affected by chronic lymphocytic leukemia. However, there are a number of treatments to control this disease.

It is still not clear to doctors as to why and how people are affected by this disease. However, it has been established that there is a genetic mutation in the DNA of the cells that produce blood and abnormal lymphocytes are produced as a result of this mutation. Complications arise when the abnormal lymphocytes accumulate in certain organs as well as in blood. When this occurs, healthy cells are forced out of the bone marrow and the lymphocytes interfere with the normal production of blood cells.

people with early-stage lymphocytic leukemia are usually not given any treatment. Doctors generally monitor the condition and only act when the condition deteriorates. For people suffering from intermediate and advanced stages of this disease, the different treatment methods include targeted drug therapy, immunotherapy, chemotherapy and bone-marrow transplant. Supportive care may also be required.

Who is eligible for the treatment? (When is the treatment done?)

There are a number of tests that can help a doctor to understand whether a person is suffering from chronic lymphocytic leukemia. Doctors generally do not provide any specific treatment to any person suffering from early-stage lymphocytic leukemia as the treatment do not provide any beneficial results as such. Doctors try to avoid putting a person through the potential side effects and the complications of treatment before the disease advances to the intermediate or advanced stages. A doctor may ask the person to go for regular check-ups and also to have his/her blood tested every few months.

However, in case the condition deteriorates, doctors will look at results of various tests that you will have to undergo and recommend the required treatment. However, the treatment may include chemotherapy which involves using drugs to kill the growing cancer cells. A doctor may suggest a single drug or a combination of drugs depending on the condition. The drugs can be injected or can also be administered via pills. Targeted drug therapy utilizes such drugs that find out the specific vulnerabilities of the cancer cells and work against them. Immunotherapy is such a treatment that boosts the body immunity of an individual. They make easier for the immune system to identify the cancer cells and even train the cells of the immune system to fight the cancerous cells. Bone marrow transplant or stem cell transplant is another mode of treatment that uses strong chemotherapy drugs to kill the stem cells in the bone marrow that create the diseased lymphocytes. Thereafter, healthy adult blood stem cells are put into the blood of the affected person and they travel to the bone marrow and begin producing healthy blood cells.

Who is not eligible for the treatment?

A doctor may diagnose a person to be suffering from chronic lymphocytic leukemia after running tests like counting the number of cells in his/her blood sample, determining the type of lymphocytes involved by means of a test called flow cytometry or immunophenotyping or by means of another test called the fluorescence in situ hybridization to analyze the lymphocytes for genetic abnormalities. A person who has tested positive for the disease after undergoing such tests is eligible for treatment.

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Are there any side effects?

A person who has not been diagnosed by a registered medical practitioner to be suffering from this condition is not eligible for treatment. Again, if a person does not experience symptoms like fever, fatigue, night sweats, frequent infections, weight loss, enlarged lymph nodes and pain in the upper left portion of the abdomen is not suitable for treatment.

What are the post-treatment guidelines?

Some of the side-effects of chemotherapy may include hair loss, easy bruising and bleeding, constipation, nausea and vomiting, anemia, infection, fatigue and appetite changes. Side-effects of targeted drug therapy may include skin problems, high blood pressure, problems with wound healing and blood clotting and gastrointestinal perforation. Immunotherapy may produce side-effects like nausea, vomiting, loss of appetite, fatigue and chills. Bone marrow transplant may cause infections, infertility, organ damage, stem cell failure, new cancers and even death.

How long does it take to recover?

A person may have to take supportive care measures to analyze any complications that a person may experience after the primary treatment. Supportive care may include screening for risks of other forms of cancer, vaccinations to reduce the risk of infections and further monitoring of the health of the affected person.

What is the price of the treatment in India?

The recovery period will vary according to the condition of the patient. The cancer can be diagnosed at its initial stage or intermediate stage or at the final stage. The time to recover will depend on the severity of the condition and also on the person’s response to the treatment provided.

Are the results of the treatment permanent?

Cost of bone marrow transplant may vary between Rs 9 lakhs and Rs 35 lakhs in our country. Immunotherapy is a very expensive treatment and may cost more than Rs 9 lakhs. Running the diagnostics for this treatment may itself cost a person more than Rs 1 lakh. After the diagnosis, the cost will depend on the number of cycles that a patient will have to receive.

What are the alternatives to the treatment?

Treatment methods like stem cell therapy, immunotherapy or chemotherapy may help a person to deal with the disease and to keep the complications at bay. But as this disease is generally due to a genetic mutation of healthy cells of the body, a person my again suffer from this disease even after undergoing treatment. Supportive care involving regular visits to the doctor may be required for a morelong-lasting solution.

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Written ByDr. Jagdish Shinde MD - Radiothrapy,MBBSOncology
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