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Chemotherapy represents the mainstay of treatment of chronic lymphocytic leukemia (CLL) in patients who meet the criteria for initiation of therapy. In general, other cancer treatment modalities, such as surgery and radiation therapy, play a very limited role in the management of patients with CLL.

Surgery

Because chronic lymphocytic leukemia is a hematological malignancy (cancer that affects the blood and bone marrow) and does not usually form a solid tumor mass, surgery does not play a major role in the primary treatment of this condition. Surgery may, however, be necessary under certain conditions. For example, surgical removal of the spleen (splenectomy) may be necessary for CLL patients with a very enlarged spleen (splenomegaly) and low platelet counts (thrombocytopenia).

Radiation Therapy

Radiation therapy, also called radiotherapy, is usually reserved for CLL patients with very enlarged lymph nodes that cause compression of other organs resulting in respiratory problems or superior vena cava syndrome. Superior vena cava syndrome is caused by the partial blockage of the vein that carries blood from the head, neck, chest, and arms to the heart. Symptoms of this syndrome may include difficulty breathing, coughing, and swelling of the face, neck, upper body, and arms.

Irradiation of the spleen may be required for CLL patients who experience severe pain associated with very enlarged lymph nodes.