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The World’s Leading Authority for Chronic Lymphocytic Leukemia Patients

Would ibrutinib and venetoclax be a better treatment than fludarabine?

Ask the Doctor Question:

I am 66 years old and diagnosed with CLL three-years ago. My WBC auto was 71.3 three-months ago, but now jumped to 178.1. My doctor is telling me it’s time to start therapy and has recommended fludarabine. Do you think as I do, that ibrutinib and venetoclax would be a better treatment? There seems to be a lot of good coming out about those two drugs.

Answer: Our number one question anytime we hear that someone with CLL is starting a new therapy is, has your physician required you to have your genetic biomarkers tested? This is because without this information, your physician will not be able to tell whether or not certain treatments will work for you. Patients who are not getting the appropriate CLL testing risk not receiving the appropriate treatment. You can read more about the importance of our Test Before Treat initiative here:

No patient should have chemotherapy unless they have first had genetic testing! Please pay close attention to the one-pager, and you can even print it off and take it to your physician to share if you would like. Since we do not know your specific markers, it would be impossible to say if fludarabine would work for you or not.

Ibrutinib and venetoclax are both very good choices for CLL treatment. There has been a lot of information written about fludarabine on our website. Here is a link to all of those articles:

Also, please make sure you are seeing a CLL Expert. You can find a list of them here:

 If you are not close to one of those on the list you may also consider applying for our Expert Access program where you can receive a free second opinion from a CLL expert who will review all of your medical records, provide you with a free 30-minute virtual consultation, and provide their recommendations in a written report to your physician. You can find more information on that here: