• Rituximab:This has become one of the main treatment approaches and is used in combination with chemotherapy as first- or second-line treatment.
  • Ofatumumab:Used in patients who do not respond to other treatments such as chemotherapy or monoclonal antibodies. It can be given together with chlorambucil or bendamustine. It is approved for use as first-line therapy. It can also be used in patients who have relapsed following treatment with fludarabine and in patients who cannot undergo any other chemotherapy-based treatment.
  • Obinutuzumab:This can be given together with chlorambucil for initial treatment in older patients with associated medical conditions. Before taking obinutuzumab, patients must take corticosteroid to prevent reactions during the treatment. These drugs act as immunosuppressants over the longer term and may increase the risk of infection.
  • Alemtuzumab:This therapy targets the CD52 present on the surface of T-cells and the cells of CLL tumors. It has limited effectiveness and is used in patients who have not responded to chemotherapy. It can be administered subcutaneously or intravenously, though subcutaneous administration causes fewer side effects. The possible side effects include fever, chills, nausea, and rash. It has great immunosuppressive effect and may increase the risk of infection. It is currently off the market worldwide and is only authorized for compassionate use in very concrete cases such as patients with deletion of the 17p chromosome or mutation in the p53 gene.