Treatment for small lymphocytic lymphoma depends on the symptoms, the rate at which the cancer is progressing, and an individual’s particular genetic mutations, age, and overall health.
Initial treatment for individuals with small lymphocytic lymphoma without symptoms may include watchful waiting.
As small lymphocytic lymphoma progresses, treatment may include combination targeted therapies and immunotherapies, such as ibrutinib with or without rituximab, ibrutinib and Obinutuzumab, venetoclax with or without rituximab, venetoclax with Obinutuzumab, and alemtuzumab.
Chemotherapy is now rarely used to treat small lymphocytic lymphoma; however, it may still be a treatment option and is usually used in combination with targeted therapies and immunotherapies, such as chlorambucil and Obinutuzumab; fludarabine, cyclophosphamide, and rituximab; ofatumumab and chlorambucil; rituximab and chlorambucil; bendamustine; and corticosteroids, such as dexamethasone and prednisone.
Maintenance therapy for patients with small lymphocytic lymphoma who have responded to treatment may include ofatumumab, rituximab, and lenalidomide.
Patients with relapsed/refractory small lymphocytic lymphoma may be treated with ibrutinib with or without rituximab or Obinutuzumab, venetoclax with or without rituximab or Obinutuzumab, idelalisib and rituximab or Obinutuzumab, acalabrutinib with or without rituximab or Obinutuzumab, duvelisib, and lenalidomide with or without rituximab.
Treatment with allogenic stem cell (bone marrow) transplant from a living donor may provide a cure for patients with small lymphocytic lymphoma but carries a risk of complications.
Supportive care for patients with small lymphocytic lymphoma may also include vaccinations to prevent infections.
Long-term follow-up for patients with small lymphocytic lymphoma is necessary to monitor disease progression, treatment effects, and to prevent and treat any infections.