Patients with advanced stage CLL will likely start treatment immediately. However, early-stage patients are invariably given no treatment. Instead, they are monitored closely on three to six month intervals. This is one of the most difficult things for newly diagnosed, early-stage CLL patients to accept--the watch and wait approach that is taken to the management of early-stage CLL. People tend to think that they should start treatment as soon as possible in order to maximize their chances of recovery as is the case with most cancers. CLL is exceptional in this particular respect.

The reason for the watch and wait approach is that CLL is generally thought to be incurable. Treatments are usually aimed at controlling the disease and managing its symptoms (palliative) not at curing the disease (curative). Over time, most treatments lose their efficacy, and for this reason, it is generally agreed that treatment should not begin until it is necessary to control the symptoms of the disease. Even escalating lymphocyte counts often do not mandate treatment.