We are a team of Duke doctors, nurses, and researchers who study Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma and provide care to patients with this disease.
- Learn more about our clinical research trials and laboratory-based research, and how you can participate and benefit.
We have a special research focus on understanding why CLL/SLL runs in some families.
- Go straight to the Contact Us page if you wish to make an appointment today.
What is CLL/SLL
Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) is a cancer of lymphocytes, a type of white blood cells. It can be present in the blood and other sites such as lymph nodes, spleen, bone marrow, or rarely other organs.
The number of lymphocytes rises in the bloodstream as the disease progresses. This prevents the production of healthy blood cells. As the number of CLL cells increase, a patient may feel fatigued and his/her performance status might decrease.
As the disease progresses, the blood counts (hemoglobin, granulocyte, and platelet counts) may drop. This pancytopenia can cause problems such as fatigue, infections, and increased propensity to bleed. If the spleen grows in size, a patient might feel bloated and have the sensation of early satiety (filling up with food after eating only a small amount).
Learn more about CLL/SLL at cancer.net.
Many patients with CLL/SLL do not need therapy right away.
When therapy is needed, there are several types of medicines that can be used, either alone or in combination:
- Chemotherapy: for example, fludarabine, cyclophsophamide, chlorambucil
- Immune therapy: for example, rituximab, ofatumumab, obinatuzumab
- Targeted therapy: for example, ibrutinib, idelalisib
The decision on which medicine or combination to use is based on a patient’s overall health, age, other medical conditions, and mutations in the CLL cells.
There are no standard treatment options after having failed initial therapy. This is the time when a full evaluation of disease extent, risk factors and performance status need to come together to make a recommendation. The recommendation may utilize standard therapy or experimental therapy.
This is the time to visit the Duke Center for CLL for a second opinion.
Can CLL/SLL be cured?
CLL/SLL is currently considered a non-curable disease, but the disease is very treatable leading to long-term disease control. With the recent development of new novel therapies for CLL/SLL, there are many more treatment options.
In a small number of patients, an allogeneic bone marrow transplant may result in a cure. One major problem is that average age of the patient with CLL/SLL is in the 60s to 70s, an age that makes the risk for an allogeneic transplant quite high. Given the high risks for complications, including death, the doctor and patient must consider this option cautiously. If an allogeneic transplant is to be done, it must be done before the patient is too ill from progressive disease.
If you or your physician is considering a bone marrow transplant, please contact us or the Adult Bone Marrow Transplant Program.