Diagnoses & Conditions

Chronic Lymphocytic Leukemia (CLL)

Understanding CLL

Chronic Lymphocytic Leukemia (CLL) is a disease of the white blood cells that affects B-cells. B-cells originate in the bone marrow, develop in the lymph nodes, and normally fight infection by producing antibodies. In CLL, the B-cells do not work effectively and adversely affect the immune system. The disease causes an increase in B-cells in the bone marrow, which crowds out healthy cells. This disease primarily affects adults over the age of 50 and is rarely seen in children.

Symptoms of CLL

Most people do not have symptoms when diagnosed with Chronic Lymphocytic Leukemia (CLL). Some patients may present with enlarged lymph nodes. If the disease is diagnosed at a later stage, patients may report fatigue, fever, night sweats, weight loss, pain in the upper left portion of the abdomen (due to an enlarged spleen) and frequent infections. CLL is usually diagnosed through a routine blood test showing an increase in lymphocytes.

Diagnosing CLL

Diagnosing Chronic Lymphocytic Leukemia (CLL) is easily done with blood tests. Usually, a patient presents with an increased lymphocyte count greater than 5,000 cells per microliter of blood on a routine complete blood count (CBC) test. The diagnosis is based on the finding of abnormal B-cells in the blood, bone marrow, or lymphatic tissue effected. The presence of lymphocytosis (high lymphocyte count) in an adult may raise strong suspicion for CLL, and a confirmatory diagnostic test (in particular flow cytometry) should be performed.

Flow cytometry and microscopic exam of blood are the tools for proper diagnosis. Flow cytometry measures specific markers on cells. Normal B-cells express CD 19 and CD 20. In CLL, the B-cells also express CD 5 and CD23. When looking at them under the microscope, the CLL cells are smaller and more fragile than normal B-cells.

Treatment of CLL

Treatment of Chronic Lymphocytic Leukemia (CLL) may vary depending on the stage in which a person is diagnosed. Early stage CLL does not need to be treated and is termed a “watch and wait” period. CLL is a slow-growing disease, so patients can live normal lives without treatment for as long as a decade. Treatment is usually initiated when the patient’s clinical symptoms (which can include severe fatigue, fever, night sweats, weight loss, enlarged lymph nodes,) or blood counts indicate the disease has progressed to a point where it may affect the patient’s quality of life. Chemotherapy is used as treatment for CLL. There are several different regimens used to treat CLL. These agents generally allow patients to go into remission. If a patient has refractory or recurrent disease, a bone marrow transplant may be indicated. At this time, bone marrow transplant may be the only therapy considered curative for CLL.

As discussed above, patients with Chronic Lymphocytic Leukemia (CLL) produce abnormal B-cells. As normal B cells are replaced with abnormal B-cells, the ability to produce immunoglobulins (antibodies) diminishes over time, making the patient susceptible to infections. Immune globulin replacement therapy is used in the treatment of CLL to support the immune system by replacing immunoglobulins to prevent infections. Immune globulin therapy can be administered into the blood stream intravenously (IVIG) or under the skin subcutaneously (SCIG).

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The information provided on this website is not medical advice, nor is it intended to be a substitute for medical advice, diagnosis, and treatment. Always seek the advice of a physician or other qualified health provider with questions concerning a medical condition. Never disregard professional medical advice, or delay seeking it based on information provided on this website.