Chronic lymphocytic leukemia is cancer of a type of white blood cells called lymphocytes.
Chronic lymphocytic leukemia (CLL) causes a slow increase in white blood cells called B lymphocytes, or B cells. Cancer cells spread through the blood and bone marrow, and can also affect the lymph nodes or other organs such as the liver and spleen. CLL eventually causes the bone marrow to fail.
IThe cause of CLL is unknown. There is no link to radiation, cancer-causing chemicals, or viruses.
This cancer mostly affects adults, around age 70. It is rarely seen under age 40. The disease is more common in Jewish people of Russian or East European descent.
Symptoms usually develop slowly over time. Many cases of CLL are detected by blood tests done in people for other reasons or who do not have any symptoms.
Symptoms that can occur include:
Patients with CLL usually have a higher-than-normal white blood cell count.
Tests to diagnose and assess CLL include:
If your doctor discovers you have CLL, tests will be done to see how much the cancer has spread. This is called staging.
There are two systems used to stage CLL:
Some newer tests look at the chromosomes inside the cancer cells. The results can help your doctor better determine your treatment.
If you have early stage CLL, your doctor will closely monitor you. Usually, no medicines or other treatment is given for early-stage CLL, unless you have:
Chemotherapy medicines are used to treat CLL. Common ones include:
Rarely, radiation may be used for painfully enlarged lymph nodes. Blood transfusions or platelet transfusions may be required if blood counts are low.
Bone marrow or stem cell transplantation may be used in younger patients with advanced or high-risk CLL. A transplant is the only therapy that offers a potential cure for CLL.
How well a patient does depends on the stage of the cancer. About half of patients diagnosed in the early stages of the disease live more than 12 years.
Call health care provider if you develop enlarged lymph nodes or unexplained fatigue, bruising, excessive sweating, or weight loss.
CLL; Leukemia - chronic lymphocytic (CLL)
Kantarjian H, O'Brien S. The chronic leukemias. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011: chap 190.
National Comprehensive Cancer Network. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Non-Hodgkin’s Lymphomas. 2012. Version 1.2012.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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