Chronic Lymphocytic Leukemia

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Chronic lymphocytic leukemia is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell). Leukemia may affect red blood cells, white blood cells, and platelets. Read More

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Chronic Lymphocytic Leukemia

What is Chronic lymphocytic leukemia? 

Chronic lymphocytic leukemia, also known as CLL, is a kind of blood and bone marrow cancer. The term “chronic” in chronic lymphocytic leukemia is because it progresses more slowly than other forms of leukemia. The term “lymphocytic” in chronic lymphocytic leukemia is because it affects the lymphocyte cells, the cells that help the body fight against the infections. It most commonly affects the older age group.  chronic lymphocytic leukemia Picture Courtesy: what is cll Picture Courtesy: news.

What are the stages of CLL?

Stages of  CLL Chronic lymphocytic leukemia has 5 stages, which are characterized on the basis of findings.
      • Stage 0: This stage is characterized by high levels of lymphocytes only. Other parameters are normal.
      • Stage 1: This stage is characterized by high levels of lymphocytes and enlarged lymph nodes.
      • The Stage 2: It is characterized by high levels of lymphocytes, enlarged lymph nodes and spleens, and potentially enlarged liver.
      • Stage 3: This stage is characterized by high levels of lymphocytes, anemia, and enlarged lymph nodes, spleen, or liver.
      • Stage 4: This stage is characterized by high levels of lymphocytes; enlarged lymph nodes, spleen, or liver; possible anemia; and low platelets level.
There is a possibility of a sixth category; Refractory: This is when chronic lymphocytic leukemia does not respond to standard treatments being given.  

How is Chronic lymphocytic leukemia diagnosed? 

There are a series of investigations to diagnose it 
      • Blood tests include a complete blood count with differential white blood cells and immunoglobulin testing.
      • Flow cytometry and cytochemistry. 
      • Fluorescence in situ hybridization (known as FISH).
      • Bone marrow biopsy and aspiration.
      • Imaging tests include computerized tomography (CT) scans and positron emission tomography (PET).
      • Genomic and molecular testing: These tests look at the specific and unique genes, proteins, and chromosome changes of certain types of leukemia.
      • Immunophenotyping
      • Fluorescent in Situ Hybridization (FISH)- The FISH analysis is a laboratory test for a patient’s chromosomes.
      • Cytogenetic analysis.

What are the treatment options available for Chronic lymphocytic leukemia?

The treatment options for chronic lymphocytic leukemia depend on several factors, such as the cancer stage, presence of symptoms, and overall health and preferences of the patient. In the early stages, treatment is not necessary. The condition and progress are, however, carefully monitored. Chronic lymphocytic leukemia treatment options for intermediate or advanced stages include; 
  • Chemotherapy; is the use of cytotoxic drugs to destroy cancerous cells.
  • Radiation therapy; is the use of high-energy X-rays to put an end to cancer cells.
  • Targeted therapy; is the use of highly specialized medications to target the proteins in cancerous cells to prevent them from growing.
  • Immunotherapy is the use of the body’s immune system against cancer.
  • Surgery; to remove an enlarged spleen.
  • Bone marrow or peripheral blood stem cell transplant.
  • Blood transfusion.


What are the most common signs and symptoms of Chronic lymphocytic leukemia?

symptoms of Chronic lymphocytic leukemia

Picture Courtesy: Janssenoncology

Many people dealing with chronic lymphocytic leukemia show no early symptoms. Those who later develop symptoms may experience;

      • Enlarged, painless lymph nodes.
      • Fatigue.
      • Fever and chills.
      • Pain in the upper left side of the abdomen may be a result of an enlarged spleen.
      • Night sweats.
      • Weight loss.
      • Frequent infections or illness.
      • Loss of appetite or early satiety.
      • Abnormal bruising.



What are the most common causes of Chronic lymphocytic leukemia?

There’s no certainty yet about what kick-starts the process that leads to chronic lymphocytic leukemia. To an extent, what is known is something that happens which leads to a genetic mutation in the DNA of the blood-producing cells. This mutation makes the blood cells produce abnormal, ineffective lymphocytes.

When normal lymphocytes die, these abnormal lymphocytes continue to live and proliferate. The abnormal lymphocytes then accumulate in the blood and certain organs, where they cause complications. They may also crowd healthy cells of the bone marrow and interfere with the production of normal blood cells.


What is the survival rate of Chronic lymphocytic leukemia? 

The 5-year survival rate for chronic lymphocytic leukemia is not less than 80%. This is, however, lower in older people with the condition. 


Are there any risk factors associated with chronic lymphocytic leukemia?

      • Age; it is commonly diagnosed in people over the age of 50.
      • Sex; more men are affected than women.
      • Ethnicity and race; are more common among people of Russian and European descent.
      • Monoclonal B-cell lymphocytosis.
      • Family history of blood and bone marrow cancer.
      • Exposure to certain chemicals can cause cancer in the long term exposure. 


What are the complications of chronic lymphocytic leukemia?

Complications likely to occur as a result of chronic lymphocytic leukemia include;

      • Frequent infections or illnesses.
      • A change to a more aggressive form of cancer.
      • Increased risk of other forms of cancers. 
      • Immune system problems.


Are there any side effects of chronic lymphocytic leukemia treatment?

The medicines used in chronic lymphocytic leukemia treatment may cause some significant side effects, such as:

      • Persistent tiredness.
      • Nausea.
      • An increased risk of infections.
      • Anemia, shortness of breath, weakness, and pale skin.
      • Hair loss or thinning.
      • Irregular heartbeat.
      • Allergic reaction.


How does Chronic lymphocytic leukemia affect the body?

The stem cells present in the bone marrow produce two types of stem cells. They are myeloid stem cells and lymphoid stem cells. The myeloid stem cells can become one of the three blood cells: red blood cells (RBC), white blood cells (WBC), or platelets. In comparison, lymphoid stem cells can form one of the three types of lymphocytes (white blood cells), either B-lymphocytes, T-lymphocytes, or NK cells (natural killer cells). Whenever a person is diagnosed with CLL, the body tends to produce abnormal lymphocytes. These cells do not fight against infections. As the abnormal cells grow, the body will have less space for RBC, WBC, and platelet cells.