Chronic lymphocytic leukemia is cancer of a type of white blood cells called lymphocytes.
Chronic lymphocytic leukemia (CLL) causes a slow increase in the number of white blood cells called B lymphocytes, or B cells, in the bone marrow. The cancerous cells spread from the blood marrow to the blood, and can also affect the lymph nodes or other organs such as the liver and spleen. CLL eventually causes the bone marrow to fail, resulting in low blood counts, and weakens the immune system.
The reason for this increase in B cells is unknown. There is no link to radiation, cancer-causing chemicals, or viruses.
CLL primarily affects adults. The average age of patients with this type of leukemia is 70. It is rarely seen in people younger than 40. The disease is more common in Jewish people of Russian or East European descent, and is uncommon in Asians.
Symptoms usually develop slowly over time. Many cases of CLL are detected by blood tests done in people for other reasons or who do not have any symptoms.
Symptoms that can occur include:
Patients with CLL usually have a higher-than-normal white blood cell count.
Tests to diagnose and assess CLL include:
If your doctor discovers you have CLL, tests will be done to see how much the cancer has spread. This is called staging.
There are two systems used to stage CLL:
Some newer tests analyze the chromosomes in the leukemia cells.The results can help predict prognosis and help guide how strong or aggressive the treatment needs to be.
For most patients with early stage CLL, no treatment is started. However, these people must be closely watched by their doctor.
If chromosome tests indicate a more high risk type of leukemia, treatment may be started earlier.
Treatment may also be started if:
Several chemotherapy drugs are commonly used to treat CLL.
Rarely, radiation may be used for painfully enlarged lymph nodes. Blood transfusions or platelet transfusions may be required if blood counts are low.
Bone marrow or stem cell transplantation may be used in younger patients with advanced CLL. Right now, transplant is the only therapy that offers a potential cure for CLL.
The outlook depends on the stage and behavior of the disease. Half of patients diagnosed in the earliest stages of the disease live more than 12 years. Some people may not require any treatment at all, while others may have faster spreading disease that requires aggressive therapy with multiple chemotherapy agents.
Newer tests that look at cell genetic changes may be done to help predict disease behavior and thus guide treatment approaches.
Call health care provider if you develop enlarged lymph nodes or unexplained fatigue, bruising, excessive sweating, or weight loss.
CLL; Leukemia - chronic lymphocytic (CLL)