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Chronic Lymphocytic Leukemia (CLL)

Chronic Lymphocytic Leukemia or CLL (also known as Leukemia - chronic lymphocytic) is cancer of the white blood cells (lymphocytes) primarily affecting adults whose average age is 70. It is rarely seen in people younger than 40.

Chronic lymphocytic leukemia causes a slow increase in the number of white blood cells called B cells in the bone marrow. The cancerous cells spread from the blood marrow to the blood, and can also affect the lymph nodes and other organs. CLL eventually causes the bone marrow to fail and weakens the immune system.

Causes or risk factors for CLL

Chronic lymphocytic leukemia causes a slow increase in the number of white blood cells called B cells in the bone marrow. The reason for this increase in B cells is unknown. There is no link to radiation, cancer-causing chemicals, or viruses.

The disease is more common in Jewish people of Russian or East European descent, and is uncommon in Asians.

Symptoms of CLL

Although CLL is often detected by routine blood tests in people who do not have any symptoms, some of the symptoms that can occur are:

  • Abnormal bruising (occurs late in the disease)
  • Enlarged lymph nodes, liver, or spleen
  • Excessive sweating, night sweats
  • Fatigue
  • Fever
  • Infections that keep coming back (recur)
  • Loss of appetite or becoming full too quickly (early satiety)
  • Unintentional weight loss

Diagnostic tests and exams for CLL

  • Complete blood count (CBC) with white blood cell differential
  • Bone marrow aspiration and biopsy
  • CT scan of the chest, abdomen, and pelvis
  • Flow cytometry
  • Serum immunoglobin level
  • Serum lactate dehydrogenase (LDH) level

If cancer is discovered, additional tests will be done to see how much the cancer has spread (staging).

Treatment of chronic lymphocytic leukemia

  • Chemotherapy: Chemotherapy may be needed if fatigue, anemia, thrombocytopenia, recurrent infections, or lymph node swelling occurs.
  • Radiation therapy: Rarely, radiation may be used for enlarged lymph nodes.
  • Blood transfusions or platelet transfusions: Blood transfusions or platelet transfusions may be required.
  • Bone marrow transplantation or stem cell transplantation: These may be used in younger patients with advanced CLL. Currently, transplant is the only therapy that offers a potential cure for CLL.

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