Several newer types of therapy have transformed the treatment of chronic lymphocytic leukemia (CLL) in recent years, increasing survival and enhancing quality of life while reducing the proportion of patients who receive chemotherapy, according to two medical oncologists who practice with Regional Cancer Care Associates (RCCA), one of the nation’s largest networks of oncology specialists. RCCA serves patients at locations throughout New Jersey, Connecticut, Maryland, and the Washington, D.C., area.
“CLL is one of the most common types of leukemia in adults,” notes Manmeet Singh Ahluwalia, MD, who practices at RCCA’s Howell, NJ, office. The board-certified medical oncologist and hematologist adds that CLL accounts for roughly one in three diagnoses of leukemia in the U.S., with an estimated 23,690 new cases expected across the country in 2025.1
Joel Silver, MD, who practices at RCCA’s West Hartford, CT, office, explains that while there are many forms of leukemia, these cancers can be categorized based on how rapidly they progress and on the type of bone marrow cells they affect. “Slower-progressing leukemias are termed chronic, while faster-moving leukemia is classified as acute. Meanwhile, leukemia that causes abnormal cell growth in the bone marrow cells that develop into lymphocytes – a type of white blood cell that plays a role in the immune system – is described as lymphocytic. By contrast, when leukemia drives abnormal growth of bone marrow cells that mature into red blood cells, certain other white blood cells, or platelets, it is called myeloid or myelogenous leukemia. So CLL is a slower-progressing leukemia affecting the production of white blood cells that are critical to immune function,” says the board-certified medical oncologist and hematologist.
While CLL progresses at a relatively slow rate, the progress being made against the disease has been rapid. “Data from the National Cancer Institute shows that the CLL death rate has been cut roughly in half over the past 30 years, with the 5-year relative survival rate now slightly above 88%,”2 says Dr. Ahluwalia. He adds, “Much of that progress has come in just the last few years, as advances in our understanding of the biology of CLL have guided development of therapies that enable us to target each patient’s disease in a very specific manner.”
Dr. Silver explains, “A decade or more ago, CLL frequently was treated with chemotherapy agents, such as chlorambucil, fludarabine and cyclophosphamide.3 Today, oncologists can draw upon more than 25 FDA-approved therapies to individualize our treatment plans for patients.4 Most of these agents are not chemotherapies but instead inhibit the molecular pathways and signaling that facilitate CLL progression.3 Beyond those targeted therapies, there is a considerable research focus on the use of immunotherapy, which enhances the immune system’s ability to recognize and attack cancer cells, to treat CLL.”
Dr. Ahluwalia says, “Thanks to these advances, chemotherapy plays a less-prominent role in the management of CLL than it did just a few years ago. While patients understandably welcome this news because of the potential side effects of chemo, it is important to keep four points in mind when you and your oncologist are discussing treatment plans. First, because CLL progresses slowly, between 15% and 30% of patients may be able to defer treatment for many years so long as they are closely monitored and do not have evidence of worsening.5
“Second, all therapies carry the potential for adverse effects, and while the side effects of targeted therapies often are milder than those seen with chemotherapy, it remains important to be alert for potential problems and promptly report them to your doctor. Third, chemotherapy remains a valuable, life-prolonging treatment for many patients, so if it is the preferred choice for you based on the nature of your CLL, that is not a bad thing or some sort of ‘defeat.’ Rather, it means that you can make use of a treatment that offers the best outcomes for your particular situation. Fourth and finally, our progress in developing agents to treat CLL has been matched by advances in our ability to prevent and mitigate the side effects of therapy, including chemotherapy. As a result, we are able to treat CLL in a way that not only extends life but that also protects quality of life.”
Dr. Silver adds, “In more than 30 years of practicing oncology, I have been privileged to witness dramatic advances in our ability to treat many forms of cancer and to employ those advances in caring for my patients. CLL represents one of the great success stories in this regard. We absolutely need to make further progress, as more than 4,400 people across the U.S. are expected to lose their lives to the CLL this year,1 but at the same time, people newly diagnosed with chronic lymphocytic leukemia have never had greater cause for hope, and more advances are on the near horizon.”
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Dr. Ahluwalia and Dr. Silver are among 100+ medical oncologists and hematologists who practice with RCCA at 25 locations across New Jersey, Connecticut, Massachusetts, Maryland, and the Washington, D.C., area. RCCA’s cancer specialists see more than 30,000 new patients each year and provide care to more than 265,000 established patients, collaborating closely with those patients’ other physicians. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, as well as access to approximately 300 clinical trials. In addition to serving patients who have solid tumors, blood-based cancers, and benign blood disorders, RCCA care centers also provide infusion services to people with a number of non-oncologic conditions—including multiple sclerosis, Crohn’s disease, asthma, iron-deficiency anemia, and rheumatoid arthritis—who take intravenously-administered medications.
To learn more about RCCA, call 844-410-7301, contact us or request an appointment.
References
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call 844-346-7222. You can also schedule an appointment by calling the RCCA location nearest you.
Leukemia diagnoses are rising in northern New Jersey even as they fall nationwide, with Sussex and Morris counties outpacing the statewide average. Board-certified hematologist and
One of the most effective ways to treat cancer is to harness the power of the body’s own immune system. This method is called immunotherapy.
Hematologic cancer, or blood cancer, is one of the most common diagnoses treated at Regional Cancer Care Associates. Blood cancer refers to types like leukemia
Sources: 1. American Cancer Society. Key Statistics for Chronic Lymphocytic Leukemia (CLL). Available at https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/about/key-statistics.html. Accessed March 30, 2025. 2. National Cancer Institute. Cancer Stat Facts: Leukemia — Chronic Lymphocytic Leukemia (CLL). Available at https://seer.cancer.gov/statfacts/html/clyl.html. Accessed March 30, 2025.
Regional Cancer Care Associates is one of fewer than 200 medical practices in the country selected to participate in the Oncology Care Model (OCM); a recent Medicare initiative aimed at improving care coordination and access to and quality of care for Medicare beneficiaries undergoing chemotherapy treatment.
