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Chronic Lymphocytic Leukemia

Getting a Diagnosis continued...

Your doctor will give you a blood test if he thinks you may have CLL. The results show how many lymphocytes, platelets, and red and white cells are in your blood.

If you need treatment, you will get a bone marrow aspiration and biopsy:

  • Aspiration: Your doctor inserts a thin, hollow needle into the bone (usually, your hip) to take out a small amount of liquid marrow.
  • Biopsy: Your doctor uses a slightly larger needle to remove a small amount of bone, marrow, and blood.

Your doctor will do both procedures during the same visit.

By checking the samples under a microscope for abnormal cells, your doctor can tell how much CLL is in your body and how fast it's moving.

Questions for Your Doctor

  • What's the stage of my leukemia?
  • Do I need treatment now?
  • If not, how will we know when I need treatment?
  • Will I need other tests before we decide?
  • Should I get a second opinion?
  • What are the side effects of treatment?
  • How will it affect my daily life?
  • What will we do if the leukemia returns?


If you have early stage CLL, you probably don't need treatment. Studies show that it doesn't help, as with some other cancers.

Even so, you should keep up with all your doctor visits. Your doctor will closely check to make sure your condition hasn't changed.

You may start treatment if your doctor notices a change, like the number of lymphocytes in your blood growing quickly, a decline in the number of your red blood cells, or swelling in a lymph node gets bigger.

Your treatment may include:

Chemotherapy. You may get this by pill, shot, or IV. Fludara (fludarabine) tends to work best to treat CLL. But doctors often combine two or more drugs that work in different ways to kill the cancer cells.

Immunotherapy. This uses lab-made antibodies, disease fighters, to attack the cancer without harming normal cells. It's often used with chemotherapy as a first treatment.

Radiation therapy. This type of treatment uses high-energy rays, such as X-rays, to destroy cancer cells. You probably won't need it, unless your doctor recommends it to shrink swelling in a lymph node, spleen, or other organ that's causing pain.

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