Chronic Lymphocytic Leukemia: Causes, Symptoms, Diagnosis and Treatment

Chronic lymphocytic leukemia is a type of cancer of the blood and bone marrow, which is the spongy tissue inside the bones where blood cells are made.

The term “chronic” in chronic lymphocytic leukemia comes from the fact that this leukemia generally progresses more slowly than other types of leukemia. The term ‘lymphocyte’ in chronic lymphocytic leukemia refers to the cells affected by the disease: a group of white blood cells called lymphocytes, which help the body fight infection.

Chronic lymphocytic leukemia most commonly affects older people. Treatments are available to help control the disease.

Many people with chronic lymphocytic leukemia have no symptoms at first. Signs and symptoms may develop as the cancer progresses. They can include the following:

Enlarged lymph nodes, but no pain Fatigue Fever Pain in the upper left side of the abdomen, possibly due to an enlarged spleen Night sweats Weight loss Frequent infections

Make an appointment with your doctor if you have persistent signs and symptoms that worry you.

Factors that may increase the risk of chronic lymphocytic leukemia include the following:

Your age.

The disease mainly affects the elderly.

Your breed.

Caucasians are more likely to develop chronic lymphocytic leukemia than people of other races.

Family history of blood and bone marrow cancer.

A family history of chronic lymphocytic leukemia or other blood and bone marrow cancers may increase the risk.

Exposure to chemicals.

Certain herbicides and insecticides, including Agent Orange, used during the Vietnam War, have been linked to an increased risk of chronic lymphocytic leukemia.

A condition that causes an excess of lymphocytes.

Monoclonal B cell lymphocytosis causes an increase in the number of a type of lymphocyte (B cell) in the blood. In some people who have

B-cell monoclonal lymphocytosis

, the disease can progress to chronic lymphocytic leukemia. if you are in pain

B-cell monoclonal lymphocytosis

and you also have a family history of chronic lymphocytic leukaemia, you may be at increased risk of developing cancer.

Tests and procedures used to diagnose chronic lymphocytic leukemia include blood tests designed to:

Count the number of cells in a blood sample.

To count the number of lymphocytes in a blood sample, a complete blood count is performed. A high number of B cells, a type of lymphocyte, may indicate chronic lymphocytic leukemia.

Determine the type of lymphocytes involved. A test called flow cytometry or immunophenotyping helps determine if a higher than normal number of lymphocytes is due to chronic lymphocytic leukemia, another blood disorder, or your body’s reaction to another process, such as an infection.

If chronic lymphocytic leukemia is present, flow cytometry can also help analyze leukemia cells for characteristics that help predict their aggressiveness.

Analyze lymphocytes to detect genetic changes.

A test called fluorescence in situ hybridization examines the chromosomes inside cancerous lymphocytes to detect changes. Doctors sometimes use this information to determine your prognosis and help you choose treatment.

In some cases, the doctor may order additional tests and procedures to help diagnose, such as:

Leukemia cell tests that look for features that may affect your prognosis Bone marrow puncture and biopsy Imaging tests, such as CT scans and PET scans

Once the diagnosis is confirmed, the doctor uses information about your cancer to determine the stage of your chronic lymphocytic leukemia. The stage tells the doctor how aggressive the cancer is and how quickly it is likely to get worse.

Chronic lymphocytic leukemia stages can use letters or numbers. In general, the early stages of the disease do not require immediate treatment. People with terminal cancer can consider starting treatment right away.

Treatment options for chronic lymphocytic leukemia depend on several factors, such as the stage of the disease, whether you have signs and symptoms, your general health, and your preferences.

If chronic lymphocytic leukemia is not causing symptoms and showing signs of worsening, you may not need immediate treatment. Some studies have shown that early treatment does not prolong the life of people with early CLL.

Instead of exposing you to the potential side effects and complications of treatment before you need it, doctors carefully monitor your condition and reserve treatment if the leukemia progresses.

Your doctor will plan a monitoring program for you. You may need to see your doctor and have blood tests every few months to monitor the progress of the disease.

If your doctor determines that your chronic lymphocytic leukemia requires treatment, your options include:

Chemotherapy.

Chemotherapy is a drug treatment that kills growing cells, including cancer cells. Chemotherapy treatments can be given through a vein or as tablets. Depending on your situation, the doctor will give you a single chemotherapy drug or a combination of several.

Targeted drug therapy.

Targeted drug treatments target specific abnormalities present in cancer cells. By blocking the abnormalities, these types of treatments can kill cancer cells.

Immunotherapy.

Immunotherapy uses your immune system to fight cancer. Your body’s disease-fighting immune system may not attack cancer because cancer cells make proteins that help them hide from immune system cells. Immunotherapy works by interfering with this process.

Bone marrow transplant. In a bone marrow transplant, also known as a stem cell transplant, powerful chemotherapy drugs are used to kill bone marrow stem cells that create disease-affected lymphocytes. Your blood is then infused with blood stem cells from a healthy adult, which travel to your bone marrow and start making healthy blood cells.

Since more effective drug combinations have been developed, bone marrow transplantation is no longer as common for the treatment of chronic lymphocytic leukemia. Still, it can be a treatment option in some situations.

The treatments can be used alone or in combination.

Your doctor will see you regularly to monitor any complications you may have. Supportive care measures can help prevent or relieve signs or symptoms.

Supportive care may include:

Cancer screening studies.

Your doctor will assess your risk for other types of cancer and may recommend screening tests to look for signs of other types of cancer.

Vaccines to prevent infections.

Your doctor may recommend certain vaccines to reduce your risk of getting infections, such as pneumonia and the flu.

Control of other health problems.

Your doctor may recommend regular checkups to monitor your health during and after treatment for chronic lymphocytic leukemia.