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Chronic Lymphocytic Leukemia (CLL): Watchful Waiting

What is watchful waiting? 

Watchful waiting is when treatment is not started right after someone is diagnosed with a disease. It’s also known as active surveillance or observation. The goal is to keep track of the disease closely to see if it gets worse or starts to cause any symptoms.

Why watchful waiting is used for CLL

Watchful waiting is often a good option for people with early stage CLL that isn’t causing symptoms. In these cases, it may be better to wait to begin any treatment, especially one that could cause severe side effects. Research has proved that for early stage CLL, watchful waiting doesn't cause harm compared with immediate treatment.                                                                                           

What happens during watchful waiting for CLL

Your doctor will keep track of your leukemia to see if it gets worse or if you begin to have symptoms that need treatment. You will need to have your blood drawn on a regular basis to check your blood cell counts. Your doctor may do this every few weeks to every few months. Your doctor will also watch for:

  • Recurring infections

  • Rapid swelling in certain organs, such as your lymph nodes, liver, or spleen

These changes may mean that the disease is getting worse.

CLL usually progresses much more slowly than acute types of leukemia. Many people can live with the disease for a long time without any problems.

Watching for symptoms

Let your healthcare provider know if you have any of these symptoms:

  • Fever or other signs of infection

  • Chills

  • Night sweats

  • Unexplained weight loss

  • Increased tiredness

  • Pain in the abdomen

  • A feeling of fullness in the abdomen

  • Enlarged lymph nodes, often felt as lumps under the skin

  • Bleeding or bruising easily

If you start having symptoms or if your doctor sees signs that the leukemia is progressing, you can then start treatment. The type of treatment you have depends on the stage of your CLL and other factors.

Online Medical Reviewer: Alteri, Rick, MD
Online Medical Reviewer: Cunningham, Louise, RN
Date Last Reviewed: 10/1/2015
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