Bendamustine hydrochloride (TREANDA®)

Bendamustine hydrochloride (TREANDA®) is a medicine which is used for the treatment of previously untreated chronic lymphocytic leukemia (CLL). Bendamustine hydrochloride has been shown to cause cell death. The exact way in which Bendamustine hydrochloride kills cells is not completely understood.

Side effects may include:

  • Fever
  • Nausea, vomiting
  • Fatigue
  • Diarrhea
  • Constipation
  • Serious infections
  • Secondary cancers
  • Myelosuppression (decreased production of blood cells)


Cyclophosphamide (PROCYTOX)

Cyclophosphamide (PROCYTOX) can be used alone or in combination with other medication to treat CLL. Cyclophosphamide interferes with the growth of cancer cells by slowing their growth and spread in the body. Cyclophosphamide may also affect the growth of normal body cells. This could lead to undesirable side effects.

Side effects may include:

  • Bone marrow suppression
  • Causing other types of cancers with long-term use
  • Cardiac toxicity
  • Severe QT/QTc prolongation (disturbances in heart rhythm)
  • Lung injury
  • Liver injury
  • Increased kidney and bladder injury
  • Serious allergic reaction
  • Vaccine induced infection when used in patients who have received live-vaccine

Fludarabine phosphate (FLUDARA®)

Fludarabine phosphate (FLUDARA®) is used as a monotherapy in second-line treatment for patients with CLL who have failed other conventional therapies. It is also used as a first-line treatment for fit patients in combination with rituximab and cyclophosphamide.

All cells of the body produce new cells of the same kind by dividing. For this purpose, the cells’ genetic material (DNA) must be copied and reproduced. Fludarabine phosphate works by hindering the production of new DNA. Therefore, when the cells take up fludarabine phosphate, it stops the growth of new cells. It has been discovered that fludarabine phosphate works especially well against some cancers of the type of white blood cells called lymphocytes.

Side effects may include:

  • Bone marrow suppression
  • Central nervous system problems
  • Low red blood cell count


Chlorambucil (LEUKERAN®)

Chlorambucil (LEUKERAN®) is used alone in the treatment of CLL.

It interferes with the growth of cancer cells which eventually are killed. Normal cells may also be affected which may lead to side effects.

Side effects may include:

  • Bone marrow suppression
  • A temporary reduction in the amount of new blood and bone marrow cells produced in the body
  • Allergic reactions
  • Harm to an unborn fetus
  • Secondary cancers particularly after long term use
  • Severe skin rash