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Because chronic lymphocytic leukemia (CLL) is rarely curable, many patients develop recurrent disease after treatment. Recurrent disease means that the leukemia has come back after the patient had gone into remission. Other patients with CLL may become resistant to one or more of the chemotherapy drugs that are used for treatment. This is known as refractory disease. Refractory means that the leukemia has failed to go into remission following treatment. Treatment options for patients with recurrent or refractory CLL include:

• Treatment with purine nucleoside analogues such as fludarabine or pentostatin
• Treatment with alkylating agents such as chlorambucil or cyclophosphamide
• Monoclonal antibody immunotherapy with alemtuzumab (Campath) has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of recurrent or refractory CLL
• Stem cell transplantation
• Combinations of the above treatments

• Clinical trials - Patients with recurrent or refractory CLL may wish to discuss with their oncologist the risks and benefits of enrolling in a clinical trial in which experimental treatments for CLL are being investigated. Information about clinical trials can be also obtained from:

  • CenterWatch Clinical Trials Listing Service: http://www.centerwatch.com
  • National Cancer Institute: http://www.cancer.gov/clinicaltrials