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Since early treatment does not improve survival, early-stage disease often requires no specific treatment, but close observation is important. Chemotherapy may be needed if a patient develops fatigue, anemia, thrombocytopenia, or enlarged lymph nodes that are troublesome.
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The anti-cancer medicine (chemotherapy) used first is usually fludarabine. Other medicines that may be used in this disease include chlorambucil (Leukeran) and cyclophosphamide (Cytoxan).
The treatment of CLL is changing rapidly. Recently, several new drugs, including alemtuzumab (Campath) -- which is an antibody against the surface of CLL cells -- has been approved for treatment of patients with CLL who have failed fludarabine. Another antibody drug, rituximab (Rituxan), may also be used alone or in combination with traditional chemotherapy. Rarely, radiation may be used for enlarged lymph nodes. Blood transfusions or platelet transfusions may be required.
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