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Measuring Treatment Response

People with chronic lymphocytic leukemia (CLL) have a range of responses after treatment. The National Cancer Institute sponsored Working Group has recommended categories and guidelines to define treatment response. The table below describes each category. Talk with your doctor about your treatment results.

Responses to CLL Therapy

Complete response (CR)
  • No clinical sign of the disease for at least two months after treatment is completed
  • Normal blood count
  • Hemoglobin levels greater than 11 grams per deciliters (g/dL) without transfusions
  • No CLL symptoms or enlarged lymph nodes, enlarged spleen or bone marrow involvement
Partial response (PR)
  • At least a 50% reduction in the number of blood lymphocytes
  • At least a 50% reduction in enlarged lymph node and spleen sizes
  • One or more of the following for at least two months:
    • Platelet levels greater than 100,000 micrograms per liter
    • Hemoglobin levels greater than 11 g/dL
    • A 50% improvement over pretreatment red cell or platelet counts without transfusions
Nodular partial response Same factors as a complete response but with persistent lymphocytic nodules in the marrow
Progressive disease

At least one of the following:

  • An increase of at least 50% in absolute lymphocyte count or transformation to higher-risk disease
  • An increase of at least 50% in liver or spleen size or a newly enlarged liver or spleen
  • An increase of at least 50% in the combined size of at least two lymph nodes found in two consecutive exams performed two weeks apart
  • New appearance of enlarged lymph nodes
Stable disease An absence of complete response or partial response, without progressive disease

Minimal Residual Disease

Some people with CLL have a very low level of remaining CLL cells after treatment. The remaining CLL cells are called minimal residual disease (MRD). The usual blood and marrow tests can't detect MRD. Your doctor may examine your blood or bone marrow using extra sensitive molecular tests such as four-color cell flow cytometry and polymerase chain reaction (PCR) for any remaining cancer cells. If MRD is detected and you're considered in relapse, your doctor will likely start treatment again.

last updated on Friday, May 11, 2012
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