Chronic lymphocytic leukemia (CLL) can go into remission after treatment. Remission can last for years for some people. However, remission does not usually mean that CLL has been cured.
What does remission mean in CLL?
Remission means that CLL has responded to treatment. Doctors may describe the response as a complete remission or partial remission.
In a complete remission, standard tests no longer find signs of CLL. Blood counts improve, and CLL-related enlarged lymph nodes or spleen are no longer present. A partial remission means CLL has improved, but some signs remain.
Your care team may use blood tests and a physical exam to check your response. Some people may also have imaging or a bone marrow test.
Does remission mean CLL is cured?
CLL is generally considered treatable but not curable with standard therapies. There is no accepted definition of a cure for CLL yet.
One research review proposed a possible definition. It described a cure as a remission lasting more than 10 years without ongoing treatment. Read more in: Is There a Cure for CLL?
Researchers are studying whether today's treatments could lead to very long remissions for some people.
What is a deep remission?
Doctors and researchers can measure very small amounts of CLL after treatment. This is called minimal residual disease (MRD).
Undetectable MRD (uMRD) means the test did not find CLL cells at its level of detection. Sensitive tests can look for very small numbers of CLL cells in the blood or bone marrow.
Studies have linked uMRD after some treatments with longer periods before CLL gets worse. However, you can have a complete or partial remission without reaching uMRD.
Can you be in remission while taking CLL treatment?
Yes. Some CLL treatments are taken continuously to keep CLL controlled.
BTK inhibitors are one example. These medicines block signals that CLL cells use to survive. Treatment may continue until CLL gets worse or side effects require a change.
Other treatments are given for a set amount of time. Venetoclax (Venclexta, AbbVie/Genentech) combinations can lead to deep responses that continue after treatment ends.
What happens if CLL returns after remission?
CLL can become active again after a period of remission. This is called a relapse. In CLL, relapse means the cancer gets worse after a partial or complete remission that lasted at least six months.
Relapse does not always mean you need treatment right away. Your care team will look at your symptoms, blood counts, lymph nodes, and other changes. Your past treatments and CLL test results can also help guide the next step.
What remission can mean for you
CLL remission can look different from person to person. It may be partial, complete, or deep enough that sensitive tests cannot find CLL cells. Regular follow-up helps your care team track the CLL and decide if more treatment is needed.
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