Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is a type of cancer of the bone marrow and blood cells. Bone marrow is the soft, spongy tissue inside your bone. In CLL, the bone marrow makes too many white blood cells that usually fight infection in the body (lymphocytes). CLL is the most common type of adult leukemia.

CAUSES

No one knows the exact cause of CLL. There is a higher risk of CLL in people who:

  • Are over 50 years of age.

  • Are white.

  • Are male.

  • Have a family history of CLL or other cancers of the lymph system.

  • Are of Russian Jewish or Eastern European Jewish descent.

  • Have been exposed to certain chemicals, such as Agent Orange (used in the Vietnam War) or other herbicides or insecticides.

SYMPTOMS

At first, some people do not have symptoms of chronic lymphocytic leukemia. After a while, people may notice some symptoms, such as:

  • Feeling more tired than usual, even after rest.

  • Unplanned weight loss.

  • Heavy sweating at night.

  • Fevers.

  • Shortness of breath.

  • Decreased energy.

  • Paleness.

  • Painless, swollen lymph nodes.

  • A feeling of fullness in the upper left part of the abdomen.

  • Easy bruising and/or bleeding.

  • More frequent infections.

DIAGNOSIS

  • During a physical exam, your caregiver may notice an enlarged spleen, liver and/or lymph nodes.

  • Blood and bone marrow tests are performed to identify the presence of cancer cells.

  • A CT scan may be done to look for swelling or abnormalities in your spleen, liver, and lymph nodes.

TREATMENT

Treatment options for CLL depend on the stage and the presence of symptoms. There are a number of types of treatment used for this condition, including:

  • Targeted drugs. These are drugs that interfere with chemicals that leukemia cells need in order to grow and multiply.

  • Chemotherapy drugs. These medications kill cells that are multiplying quickly, such as leukemia cells.

  • Biological therapy. This treatment boosts the ability of the patient's own immune system to fight the leukemia cells.

  • Bone marrow or peripheral blood stem cell transplant. This treatment allows the patient to receive very high doses of chemotherapy and/or radiation. These high doses kill the cancer cells, but also destroy the bone marrow. After treatment is complete, the patient is given donor bone marrow or stem cells, which will replace the bone marrow.

HOME CARE INSTRUCTIONS

  • Because you have an increased risk of infection, practice good hand washing and avoid being around people who are ill or crowded places.

  • Because you have an increased risk of bleeding and bruising, avoid contact sports or other rough activities.

  • Only take over-the-counter or prescription medicines for pain, discomfort or fever as directed by your caregiver.

  • Although some of your treatments might affect your appetite, try to eat regular, healthy meals.

  • If you develop any side effects, such as nausea, diarrhea, rash, white patches in your mouth, a sore throat, difficulty swallowing, or severe fatigue, tell your caregiver. He or she may have recommendations of things you can do to improve symptoms.

  • Consider learning some ways to cope with the stress of having a chronic illness, such as yoga, meditation, or participating in a support group.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop an unexplained oral temperature of 102° F (38.9° C) or more.

  • You develop chest pains.

  • You develop a severe stiff neck or headache.

  • You have trouble breathing or feel short of breath.

  • You feel very lightheaded or pass out.

  • You notice pain, swelling or redness anywhere in your legs.

  • You have pain in your belly (abdomen).

  • You develop new bruises that are getting bigger.

  • You have painful or more swollen lymph nodes.

  • You develop bleeding from your gums, nose, or in your urine or stools.

  • You are unable to stop throwing up (vomiting).

  • You cannot keep liquids down.

  • You feel depressed.