Chronic Lymphocytic Leukemia (CLL)

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Chronic Lymphocytic Leukemia (CLL): Fast Facts

• Chronic lymphocytic leukemia (CLL) occurs when the bone marrow makes too many abnormal white blood cells, or lymphocytes, that never become healthy, infection-fighting cells.
• As the number of these abnormal lymphocytes increases, they interfere with the production of other important blood cells, leading to multiple complications, including infection, easy bleeding and swollen lymph nodes.
• CLL usually gets worse slowly.
• CLL is the second most common form of leukemia in adults and rarely occurs in children. More than half of people diagnosed with CLL are older than 70, and cases rarely occur in individuals younger than 40.

Read more about leukemia treatment at the Seattle Cancer Care Alliance. »

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Chronic Lymphocytic Leukemia (CLL): Some of Our Key Research

Bone-marrow and stem-cell transplantation procedures developed at the Hutchinson Center are largely responsible for boosting the five-year survival rates for chronic lymphocytic leukemia (CLL) from 14 percent in the 1960s to nearly 75 percent today. Center researchers are developing less-toxic transplant procedures that can extend this lifesaving treatment to older patients, who make up the largest proportion of CLL cases.

Pioneering bone-marrow transplantation
One of the Hutchinson Center's founders, Dr. E. Donnall Thomas, won the Nobel Prize in 1990 for his groundbreaking work in bone-marrow transplantation, one of the greatest success stories in cancer treatment.

Since then, Center investigators have trained physicians around the world in this procedure, and many new advances have occurred.

Read more about the Hutchinson Center's transplantation work. »

Making transplantation less toxic

• In the late 1990s, Dr. Rainer Storb and colleagues pioneered the development of a radically different approach to bone-marrow transplantation that offers hope for older or otherwise medically unfit blood-cancer patients whose bodies cannot withstand the rigors of a conventional transplant.
  
  Unlike traditional bone-marrow transplantation, this treatment—called the non-myeloablative stem-cell transplant or "mini" transplant—does not wipe out bone marrow and involves minimal doses of radiation. That means patients do not lose their hair or experience severe nausea or other side effects, and the procedure typically can be performed without a hospital stay. Learn more. »

Listen to a Webcast with Dr. Rainer Storb. »

• Dr. David Maloney has been leading clinical trials that seek to determine the effectiveness of a certain type of this lower-intensity conditioning approach, followed with an infusion of donated stem cells, in treating CLL patients.

Listen to a Webcast with Dr. David Maloney. »

Investigating new sources of transplantation cells
About one-third of all blood-cancer patients whose best curative treatment option is bone-marrow transplantation are unable to find a tissue-matched donor. One alternative is receiving a transplant that uses umbilical cord blood, which is rich in blood stem cells and can be collected without risk from the umbilical cord after birth of a child.

A major advantage of this source of cells for bone-marrow transplantation is that it does not need to be as well tissue-matched, allowing those patients who can not find a conventional donor to undergo transplantation. The major disadvantage is the small number of cells available from the cord blood. Learn more. »

Listen to a Webcast with Dr. Colleen Delaney. »

Fortifying the body against leukemia
Dr. Stanley Riddell and colleagues have been investigating use of a treatment technique for leukemia called immunotherapy—that is, harnessing the body's own infection-fighting T-cells against the disease. T-cells, however, typically die quickly, resulting in an interruption in immune response that could cause cancer to return. Through advanced testing, Riddell and colleagues found that one type of T-cell—central memory cells—had the staying power they were seeking. The approach holds promise for treating several types of cancer, including chemotherapy-resistant ALL in children. Learn more. »

Using the immune system to boost traditional treatment
Dr. John Pagel has been investigating the use of a treatment technique known as radioimmunotherapy, in an effort to eliminate any remaining disease in CLL patients and to prevent the disease from returning.

Radioimmunotherapy—in this case, an agent known by the trade name Bexxar—makes use of an antibody that is designed to deliver a small, targeted dose of radiation to specific cancer cells, such as the CLL cells. Because the antibody is able to bind to an antigen associated specifically with the tumor, this technique limits damage to the surrounding normal, healthy tissues.

Clinical trials led by Pagel are evaluating the safety and effectiveness of Bexxar in combination with more traditional chemotherapy, including Rituximab, another antibody-based drug developed thanks to pioneering work from Hutchinson Center researchers. Learn more. »

Determining quality of life after transplantation

• Many patients who undergo bone-marrow or stem-cell transplantation face a decline in mental skill and physical coordination after treatment, but a 2004 study by Dr. Karen Syrjala and colleagues has shown that these effects are largely temporary and that most patients can expect a return to normal function within a year of their transplant. A more recent analysis showed that most patients show even further improvement in brain function between one and five years after transplant. Learn more. »

• Another study led by Syrjala found that survivors of stem-cell transplantation for blood cancers can expect to be just about as healthy 10 years later as adults who have never had a transplant. The study found that transplant survivors and people who hadn’t had transplants reported similar rates of hospitalization and outpatient medical visits. They also had similar rates of diseases and conditions such as asthma, diabetes, high blood pressure, high cholesterol, osteoporosis and hypothyroidism, along with similar psychological health, marital satisfaction and employment. It is, however, very important for transplant survivors to get regular primary care and health monitoring in the years after transplant. Learn more. »

Listen to a Webcast with Dr. Karen Syrjala. »

Find out more about our CLL investigators:
Fred Appelbaum » Joachim Deeg » Colleen Delaney » Ajay Gopal » David Maloney » Paul Martin »	John Pagel » Oliver Press » Jerry Radich » Brenda Sandmaier » Andrei Shustov » Karen Syrjala » Edus "Hootie" Warren »

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Chronic Lymphocytic Leukemia (CLL): More Resources

• Every advance in cancer treatment in recent years has come out of clinical trials that test innovative medical approaches on patients.Find out more about clinical trials on chronic lymphocytic leukemia. »

• The Hutchinson Center also conducts ongoing cancer-prevention studies that depend on participation of healthy volunteers. Learn more about getting involved in research studies. » 

• In need of medical attention for chronic lymphocytic leukemia? Visit the Seattle Cancer Care Alliance to get help. »

• The Hutchinson Center is on a mission to eliminate cancer and related diseases as causes of human suffering and death, and you can help. Make a gift today. »

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