How you have targeted drugs and other cancer drugs for chronic lymphocytic leukaemia (CLL)

This page is about how you have cancer drugs for chronic lymphocytic leukaemia (CLL). The most common type are targeted cancer drugs . You might also have:

• immunotherapy
• chemotherapy  - this is now much less common than in previous years

You have them in different ways.

Most people have treatment for CLL as an outpatient .

Treatment can be:

• tablets
• an injection into a vein as a drip (intravenously)

You have treatment in cycles or blocks. Each cycle usually lasts for 28 days. You have some drugs every day and others weekly or less often. After each cycle of treatment, your team will check your side effects. They will also check how well treatment is working.

You might have up to 6 cycles of treatment. But some treatments carry on until they stop working or side effects become too severe.

You can read more about each drug in our cancer treatment section.

Having treatment

There are many different drugs for treating CLL. You might have these on their own or in a combination. The 4 main treatments are:

• either ibrutinib, acalabrutinib or zanubrutinib. These drugs are called Bruton tyrosine kinase inhibitors (BTKis). You might take one of these on their own. Or you might have ibrutinib with venetoclax.
• venetoclax either on its own, or with rituximab, obinutuzumab or ibrutinib
• idelalisib with rituximab
• chemotherapy with immunotherapy (chemoimmunotherapy). Or chemotherapy on it's own to help with symptoms.

Supportive treatments

CLL and its treatment can cause problems. Supportive treatments can help to prevent some of these problems.  

The problems you might develop depend on how the CLL is affecting your body. And it also depends on what treatment you have.

Preventing tumour lysis syndrome

When cancer drugs kill leukaemia cells, the body breaks down the dead cells. This releases chemicals into your blood. So the normal balance of chemicals circulating in your blood suddenly changes. This is called tumour lysis syndrome.

You have regular blood tests to check for this if you are at risk. You might need to take medicines called rasbirucase or allopurinol to help prevent tumour lysis syndrome. It’s also important to drink plenty of fluids.

Preventing infection

Your doctor might suggest you take medicines to reduce the risk of getting infection. These include medicines to prevent:

• bacterial infections - for example, you might take an antibiotic called co-trimoxazole
• viral infections - for example, you might take an anti viral drug called aciclovir

Taking your tablets or capsules

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

You should take the right dose, not more or less.

Talk to your specialist or advice line before you stop taking a cancer drug.

Treatment into the bloodstream

When you have treatment into your bloodstream you usually go to the hospital or a day unit. You can usually go home the same day.

Depending on the drug, you may have your treatment by injection through a small needle (cannula) into a vein over a few minutes. 

Some people have treatment through a drip over a longer period. Before each treatment you have a blood test to check your white blood cell, red blood cell and platelet counts.

Side effects

Many people are worried about the possible side effects of treatment. All treatments cause some side effects. But side effects vary from one person to another.

Side effects depend on what treatment you have. There are several types of drug treatments for CLL. These have different side effects.  You can look up your treatment drugs on our cancer drug list and read about the side effects.

Your treatment team can help to manage any side effects that you have. They might give you drugs to help with certain side effects such as anti sickness medicines.

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 
• your side effects aren’t getting any better
• your side effects are getting worse

Early treatment can help manage side effects better. 

Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

Dietary or herbal supplements

We don't know enough about how some nutritional or herbal supplements may interact with cancer drugs. Some could be harmful.

Talk to your specialist about any other tablets or medicines you take while you are having active treatment. Let your doctors know if you:

• take any supplements
• have been prescribed anything by alternative or complementary therapy practitioners

It’s unclear how some nutritional or herbal supplements might interact with treatment. They could be harmful.

Information and support