Total body irradiation using x-rays to the total body may be used in the aggressive stages of disease. Whilst killing large numbers of leukaemia cells, total body irradiation also kills healthy blood cells. As such, its use is somewhat restricted. The antibody may or may not be tagged with chemotherapy or radioactive substances. The optimal dose and regime are still being worked out, and trials are being actively conducted in many centres.
Preliminary results are very encouraging.
Side effects are often seen only in the first dose which therefore demands hospitalisation for observation. Low grade fever and mild allergic manifestations are the commoner adverse effects. It is able to assist white blood cells to kill certain bacteria. The spleen is also able to store blood, platelets and destroy damaged red blood cells and platelets. Patients with CLL frequently suffer from spleen enlargement as a result of leukaemia infiltrating the organ.