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  • Chronic Lymphocytic Leukemia

    Chronic lymphocytic leukemia (CLL) is one of the four main kinds of leukemia that exist. There are more people living with CLL than with any other type of leukemia. CLLs change lymphocytes, a type of white blood cell, into abnormal cells. These abnormal cells then multiply, replacing the healthy, normal lymphocytes both in the bone marrow and the lymph nodes. As the disease is labeled “chronic,” it does progress slowly, allowing most patients to feel well and live normally for many years. In fact, while most patients do require treatment upon diagnosis, many do not need treatment for a long period of time due to the slow progression of CLL.

    CLL is associated with a number of complications, including the development of more aggressive cancers and frequent infections, as the CLL cells that take over the body cannot combat infection like normal white blood cells are able to do.

    Chronic Lymphocytic Leukemia Risk Factors

    As doctors are still studying chronic lymphocytic leukemia and the causes of the disease are not yet defined, risk factors, too, remain unknown. However, patients have the following things in common:

    • Age: Most patients of CLL are over 50.
    • Gender: More men are diagnosed with CLL than women.
    • Race: Whites are more likely to develop CLL than any other race.
    • Family History: If chronic lymphocytic leukemia, or other blood or bone marrow cancers, run in the family, it increases an individual’s risk of developing CLL.
    • Chemical Exposure: Exposure to certain insecticides and herbicides such as Agent Orange have been linked to CLL.

    Chronic Lymphocytic Leukemia Signs and Symptoms

    Many chronic lymphocytic leukemia patients experience little to no symptoms. If symptoms are present, they typically develop very slowly and may include:

    • Fatigue
    • Weight Loss
    • Fever
    • Enlarged Lymph Nodes: While oversized, the lymph nodes are usually painless, and are located in the armpit, neck, or groin.
    • Night Sweats
    • Frequent Infections: These can be of any body part, but impact the skin in particular.
    • Shortness of Breath

    Chronic Lymphocytic Leukemia Diagnosis

    About 15,000 cases of CLL are diagnosed each year in the United States. Over 90,000 people are living with the disease today. Many CLL patients experience no symptoms. As a result, sometimes a diagnosis is made following a periodic health exam or routine lab test. Both blood tests and bone marrow tests are necessary to confirm a diagnosis. Tests used may include:

    A CBC (complete blood count): This will show the number of lymphocytes in the blood. A high number of B cells may indicate CLL.
    Bone Marrow Aspiration and Biopsy: This will be used to determine if actual leukemia cells are present. The aspiration is conducted through removing a small amount of bone marrow from the hipbone with a needle; the biopsy involves removing a part of the bone itself. These procedures can be done in a doctor’s office.
    Immunophenotyping: Also called flow cytometry, this test helps determine whether an increase in lymphocytes is actually due to the presence of leukemia, or to something else entirely, such as an infection. It can also help determine how aggressive, if present, the leukemia cells may be.

    Chronic Lymphocytic Leukemia Staging

    Once detected, doctors must find out what stage of development a patient’s CLL is at to determine what treatment is needed.

    Chronic Lymphocytic Leukemia Treatment

    Many people live normal lives with chronic lymphocytic leukemia due to the disease’s slow progression. Patients in early stages may need no treatment. There is no known cure for CLL, but there are many treatments for patients who need it. The goal of these treatments is to prolong a patient’s life. Such treatments may include:

    Chemotherapy: This treatment involves giving a drug or multiple drugs, through an injection or pill form, to kill cancer cells.
    Targeted Drugs: Drugs such as rituximab and alemtuzumab may be used to exploit the vulnerabilities of the CLL cells and kill them.
    Bone Marrow Stem Cell Transplants: New cells may be transplanted to displace and outnumber the CLL cells, creating a more normal, healthy cell environment.

    Doctors are still studying CLL and trying to find a cure.

    Chronic Lymphocytic Leukemia Outlook (Prognosis)

    While there is no known cure for chronic lymphocytic leukemia, many patients are able to live normal, healthy lives for many years. Overall survival rates are over 76%.

    Chronic Lymphocytic Leukemia Prevention

    Without many known risk factors, prevention for chronic lymphocytic leukemia is difficult. Avoiding chemicals such as insecticides and herbicides may help lower risk of development.

    Chronic Lymphocytic Leukemia Resources

    Mayo Foundation for Medical Education and Research (MFMER). 1998-2009. Retrieved May 1, 2009 from.
    The Leukemia & Lymphoma Society. April 30, 2009. Retrieved May 1, 2009 from.