Chronic lymphocytic leukemia (CLL) is a cancer of the blood in which too many lymphocytes, a type of white blood cell, are produced by the bone marrow and organs of the lymph system.
Normally, most lymphocytes fight infection by making antibodies that attack harmful elements. But, in CLL, the cells are immature and overabundant. They crowd out other blood cells, and may collect in the blood, bone marrow, and lymph tissue. CLL is a slowly progressing disease.
According to the American Cancer Society, about 15,700 cases of CLL are expected to be diagnosed in 2013, and about 4,600 people will die of CLL.
Early in the disease, there may be no noticeable symptoms, and many cases are diagnosed on routine blood tests. The following are the most common symptoms of chronic lymphocytic leukemia. However, each individual may experience symptoms differently. Symptoms may include:
Persistent weakness or fatigue
Swollen lymph nodes
Enlarged spleen, which can cause loss of appetite
Easy bruising or bleeding
The symptoms of chronic lymphocytic leukemia may resemble other blood disorders or medical problems. Always consult your health care provider for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic procedures for chronic lymphocytic leukemia may include the following:
Blood tests and other evaluation procedures
Bone marrow aspiration and/or biopsy. A procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.
Spinal tap/lumbar puncture. A special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebrospinal fluid (CSF) can be removed and sent for testing to determine if there is an infection, leukemia cells in the CSF, or other problems. CSF is the fluid that bathes the brain and spinal cord. This test isn't usually needed for CLL unless your doctor suspects a problem in the brain or spinal cord.
Specific treatment for chronic lymphocytic leukemia will be determined by your doctor based on:
Your age, overall health, and medical history
Extent of the disease
Other traits of the disease, such as chromosome changes in the leukemia cells
Whether or not you are having symptoms
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
Treatment may include:
Watchful waiting. Close monitoring of the disease and not treating it unless it begins to grow quickly or cause symptoms.
Monoclonal antibodies, such as Rituxan, Arzerra, or Campath, that provide targeted therapy
Treatment for complications, such as infection or anemia
Leukapheresis. A procedure to remove excess lymphocytes from the body.
Bone marrow or peripheral blood stem cell transplantation
Splenectomy. Surgery to remove the spleen.