What is Chronic Lymphocytic Leukemia?

Leukemia is cancer of the blood cells which form in the bone marrow. When cancerous blood cells form, they crowd out healthy blood cells. Chronic lymphocytic leukemia (CLL) is a type of cancer in which the bone marrow makes too many lymphocytes, a type of white blood cell which helps the body fight infection.

Chronic lymphocytic leukemia tends to progress more slowly than other types of leukemia, which is why it’s known as “chronic” rather than “acute.” It mostly affects older adults and it’s often treatable.

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of chronic lymphocytic leukemia. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Common symptoms of chronic lymphocytic leukemia include:

• Enlarged, painless lymph nodes
• Fatigue
• Frequent or severe infections
• Night sweats
• Pain in the upper left abdomen (enlarged spleen)
• Persistent fever
• Unintentional weight loss

Diagnosis

A physician may detect leukemia in a routine blood test before symptoms begin. If someone has symptoms of CLL, we perform a physical examination and ask questions about symptoms. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Common diagnostic procedures can include:

Bone marrow biopsy: If leukemia is suspected, a sample of bone marrow may be removed from the hip bone. The marrow is removed with a long, thin needle and tested for leukemia cells.

Complete blood count (CBC): Looking at a sample of blood, physicians can determine if abnormal levels of white blood cells are present. A high number of B cells, one type of lymphocyte, may indicate chronic lymphocytic leukemia.

Flow cytometry or immunophenotyping: This test uses a laser to analyze the physical and chemical characteristics of blood cells to determine whether an increased number of lymphocytes is due to CLL, a different blood disorder or the body’s reaction to infection.

Fluorescence in situ hybridization (FISH): This blood test examines the chromosomes inside abnormal lymphocytes to look for genetic abnormalities. 

Imaging tests: A computerized tomography (CT) scan or other imaging test may be used to look for an enlarged spleen or other signs of CLL.

Causes

Researchers don’t know the exact causes of chronic lymphocytic leukemia, which is due to a genetic mutation in the DNA of blood-producing cells. This mutation leads to production of abnormal, ineffective lymphocytes. Most believe a combination of genetic and environmental factors can lead to its development.

Risk Factors

Risk factors that can contribute to chronic lymphocytic leukemia include:

Age: Most people diagnosed with chronic lymphocytic leukemia are older than 60.

Ethnicity: Caucasians are more likely to develop CLL than people of other races.

Exposure to certain chemicals: Exposure to certain insecticides and herbicides, including Agent Orange – which was used during the Vietnam War – has been linked to an increased risk of CLL.

Family history of blood and bone marrow cancers: Disease risk may be greater if family members have been diagnosed with CLL or other blood and bone marrow cancers.

Prevention      

There is no known way to prevent chronic lymphocytic leukemia.

Prognosis

Because of its slow prognosis, people with CLL who are diagnosed and treated early can have a good prognosis.

Treatment and Recovery

Chronic lymphocytic leukemia treatment options depend on the stage of the cancer, whether a person is experiencing symptoms, and his or her overall health and preferences. Early-stage CLL may not need treatment. When treatment is required, it may include:

Chemotherapy

Special drugs designed to kill cancer cells can be given as a pill or injected into the bloodstream. A person may receive a single chemotherapy drug or a combination of drugs.

Stem Cell Transplant

This procedure replaces diseased bone marrow with healthy bone marrow. Before the transplant, a patient receives high doses of chemotherapy or radiation to destroy diseased bone marrow. Then, the patient receives an infusion of blood-forming stem cells from a healthy donor to help rebuild the bone marrow.

Targeted Therapy

These drugs attack specific vulnerabilities within the cancer cells.

Complications

Chronic lymphocytic leukemia may cause the following complications:

Frequent infections: People with CLL may experience frequent infections. Some may be serious.

Immune system problems: In some people with CLL, disease-fighting cells mistakenly attack red blood cells or platelets.

Increased risk of other cancers. People with chronic lymphocytic leukemia have an increased risk of skin cancer, such as melanoma, and cancers of the lung and the digestive tract.

Transition to a more aggressive form of cancer: A minority of people with CLL may develop a more aggressive form of cancer called diffuse large B-cell lymphoma.