What to Expect During Remission
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JONATHON B COHEN MD: Many of my patients ask, when they're diagnosed with chronic lymphocytic leukemia, what can I expect down the road? Can you cure me of this disease? And unfortunately, at least in the current age, most patients will not be cured of their disease.
And so I often spend a lot of time counseling my patients at their initial visit on what we can expect. And that is for most patients, they will enjoy a long life, frequently will feel well for the majority of that time, but may require therapy at various times throughout their course. What's most important to me when I'm evaluating a patient is that they, number one, tolerate the therapy, and number two, that their symptoms that they were experiencing prior to starting treatment have resolved.
At some point during your treatment, whether you're on chronic oral therapy or you completed a course of IV chemotherapy, you and your doctor will have a discussion about your response. And what we are looking for when we determine a response are a couple of things. First is to see if you've had normalization of your blood counts. We also look to see if you've had resolution of the symptoms that you may have been experiencing prior to starting treatment. And then we also may complete a CAT scan or some other type of scan to assess whether any of the lymph nodes that you may have had present have gone away.
And based on what we find, we often will decide whether or not you are in what we call a complete remission or a partial remission. And this is what we refer to as your response. And patients in a complete remission have had basically complete resolution of all of their sites of disease based on at least routine blood work and scans. Whereas patients that are in partial remission have had a significant improvement but still may have some residual disease.
Now regardless of whether you achieve a complete remission or a partial remission, we expect at some point that the disease likely will start to progress again. And so it's very important to have a discussion with your physician about what we'll be looking for to help us know when your disease is coming back and what we may do if we start to see that happen. And those are things that you can discuss at your ongoing follow up visits with your doctor.
And so I often spend a lot of time counseling my patients at their initial visit on what we can expect. And that is for most patients, they will enjoy a long life, frequently will feel well for the majority of that time, but may require therapy at various times throughout their course. What's most important to me when I'm evaluating a patient is that they, number one, tolerate the therapy, and number two, that their symptoms that they were experiencing prior to starting treatment have resolved.
At some point during your treatment, whether you're on chronic oral therapy or you completed a course of IV chemotherapy, you and your doctor will have a discussion about your response. And what we are looking for when we determine a response are a couple of things. First is to see if you've had normalization of your blood counts. We also look to see if you've had resolution of the symptoms that you may have been experiencing prior to starting treatment. And then we also may complete a CAT scan or some other type of scan to assess whether any of the lymph nodes that you may have had present have gone away.
And based on what we find, we often will decide whether or not you are in what we call a complete remission or a partial remission. And this is what we refer to as your response. And patients in a complete remission have had basically complete resolution of all of their sites of disease based on at least routine blood work and scans. Whereas patients that are in partial remission have had a significant improvement but still may have some residual disease.
Now regardless of whether you achieve a complete remission or a partial remission, we expect at some point that the disease likely will start to progress again. And so it's very important to have a discussion with your physician about what we'll be looking for to help us know when your disease is coming back and what we may do if we start to see that happen. And those are things that you can discuss at your ongoing follow up visits with your doctor.
