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Treatment Outcomes

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

Even when a complete remission is achieved, many leukemia cells that cannot be seen with a microscope may remain in the blood and bone marrow. The presence of these cells is referred to as “minimal/measurable residual disease (MRD).” 

The tests used most often to detect MRD are flow cytometry, polymerase chain reaction (PCR), and next-generation sequencing. Typically, these three tests use samples of blood or bone marrow cells. The tests are much more sensitive than standard tests that examine cell samples with a microscope. 

When these tests show that patients have less than one CLL cell per 10,000 lymphocytes in blood or bone marrow cell samples, the disease is in a deep state of remission, classified as MRD undetectable or MRD-negative. In research studies, patients who remained MRD-negative after the end of CLL had better treatment outcomes. An undetectable MRD status after treatment with some drug regimens for CLL is becoming an important factor for predicting prolonged effectiveness of the treatment.  

While MRD testing has become widespread in CLL clinical trials, it is not currently part of the routine patient management of CLL. This testing is not done in patients who are receiving acalabrutinib, zanubrutinib, or ibrutinib. These drugs are used to control disease; they do not fully eradicate the disease. 

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