Treatment outcomes for people with CLL vary widely, and expected outcomes are influenced by the
- Stage of the disease
- Presence or lack of various factors associated with higher-risk disease
- Overall health of the patient
- Other considerations.
Current research suggests that newer treatment combinations and approaches may improve the length of survival. People with CLL should consult with their doctors to discuss individual potential outcomes. For survival statistics, click here.
Minimal Residual Disease
Some people with CLL have such a low level of remaining CLL cells after treatment that these cells cannot be detected by the usual clinical tests, such as blood and bone marrow examinations. This is called “minimal residual disease (MRD).” More sensitive tests may be performed to detect the presence of abnormal cells, such as multicolor cell flow cytometry and polymerase chain reaction (PCR).
Having a negative MRD status after the end of treatment is emerging as an important factor that can predict the effectiveness of the treatment received. In addition, assessing MRD status can provide information to help the doctor recognize a disease relapse and decide if the continuation of treatment is necessary.
Measuring Treatment Response
People with chronic lymphocytic leukemia (CLL) have a range of responses after treatment. The table below describes various types of CLL treatment responses.
|Criteria||CR (Complete Response)||PR (Partial Response)||PD (Progressive Disease)|
|Lymph Node Involvement||None >1.5 cm||Decrease ≥50%||Increase ≥50%|
|Liver Enlargement||None||Decrease ≥50%||Increase ≥50%|
|Spleen Enlargement||None||Decrease ≥50%||Increase ≥50%|
|Bone Marrow||<30% lymphocytes No B-lymphoid nodules||50% reduction of abnormal cells in marrow or B-lymphoid nodules|
|Blood Lymphocytes||<4,000/uL||Decrease ≥50% over baseline||Increase ≥50% over baseline|
|Platelet Count (without growth factors)||>100,000/uL||>100,000/uL or increase ≥50% over baseline||Decrease ≥50% over baseline secondary to CLL|
|Hemoglobin (without transfusions or growth factors)||>11.0 g/dL||>11 g/dL or increase ≥50% over baseline||Decrease of >2g/dL from baseline secondary to CLL|
|Neutrophil Count (without growth factors)||>1500/uL||>1500/uL or >50% improvement over baseline|
Adapted from: Comprehensive Cancer Network. Practice Guidelines in Oncology—v.3.2016. Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma. Available at: www.nccn.org/professionals/physician_gls/pdf/cll.pdf. Accessed July 1, 2017; Scarfò L, Ferreri AJ, Ghia P. Chronic lymphocytic leukaemia (review). Critical Reviews in Oncology/ Hematology. 2016;104:169-82. doi:10.1016/j.critrevonc.2016.06.003.
- Download or order The Leukemia & Lymphoma Society's free booklet, Chronic Lymphocytic Leukemia.