Relapsed and Refractory

Relapsed CLL is the term for disease that returns after it has been in remission for more than six months. 

Refractory disease is the term for CLL that does not result in remission after initial therapy. 

Many patients with refractory disease can achieve a remission with different treatments, and many patients with relapsed disease can obtain another period of remission with additional treatment. This approach can control CLL for many years. Often people with CLL will require several lines of treatment in their lifetime, and they often have a good quality of life for years after receiving additional treatment. 

Before starting treatment, it is important to have another FISH test to see if there are any changes to the genes and/or chromosomes of the CLL cells. This can help your doctor determine the next therapy. New mutations can develop over time or as a result of past treatments. 

Preferred treatments:

Other recommended treatments:

  • Allogeneic stem cell transplantation
  • Bendamustine with rituximab
  • Duvelisib
  • FCR (fludarabine, cyclophosphamide and rituximab)
  • High-dose methylprednisolone with rituximab or obinutuzumab
  • Ibrutinib
  • Idelalisib, alone or in combination with rituximab
  • Lenalidomide alone or in combination with rituximab
  • Obinutuzumab
  • Venetoclax, alone or with ibrutinib or rituximab
  • Clinical trials 

For information about the drugs listed on this page, visit Drug Listings. 


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