Chemoimmunotherapy for chronic lymphocytic leukemia

Chemoimmunotherapy combines chemotherapy with monoclonal antibodies. Chemotherapy uses anticancer drugs to destroy cancer cells. Monoclonal antibodies are a type of targeted therapy. They stimulate the body's immune system to attack and destroy chronic lymphocytic leukemia (CLL) cells. Chemoimmunotherapy is a systemic therapy. This means that the drugs travel through the blood to reach and destroy cancer cells all over the body.

If you have chemoimmunotherapy, your healthcare team will use what they know about the cancer and about you and your overall health to plan the drugs, doses and schedules. It is a treatment option if you have CLL that does not have a 17p chromosome deletion or a TP53 gene mutation and the IGHV gene is mutated.

Chemoimmunotherapy is given for a limited time of around 6 months, so you may need other treatment.

The most common chemoimmunotherapy combinations used to treat CLL are:

• FCR – fludarabine (Fludara), cyclophosphamide (Procytox) and rituximab (Rituxan and biosimilars)
• BR – bendamustine (Treanda, Benvyon, Esamuze) and rituximab
• chlorambucil (Leukeran) and obinutuzumab (Gazyva)

Side effects of chemoimmunotherapy will depend mainly on the drug or drug combination, the dose, how it’s given and your overall health. Tell your healthcare team if you have side effects that you think are from chemoimmunotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Possible side effects of chemoimmunotherapy drugs for CLL include:

• low blood cell counts
• flu-like symptoms, such as fever and chills
• nausea and vomiting
• loss of appetite
• sore mouth and throat
• fatigue
• hair loss
• diarrhea and constipation
• skin problems, such as itching and redness
• infection
• fertility problems
• heart problems
• kidney problems
• tumour lysis syndrome

Find out more about chemotherapy and targeted therapy.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.