Chronic Lymphocytic Leukemia (CLL)

What is chronic lymphocytic leukemia (CLL)?

Chronic lymphocytic leukemia (CLL) is a type of cancer of the blood and bone marrow that begins when normal processes of cell division and growth are disrupted in the bone marrow, giving way to abnormal, uncontrollable growth of lymphocytes (a type of white blood cell). These white blood cells are produced to help the body fight infection, however with the abnormal production of lymphocytes, these cells do not mature and thus cannot properly function to protect the body. The high volume of unhealthy, immature lymphocytes makes it harder for healthy blood cells and platelets to thrive. This disease, most commonly found in adults, can lead to infections and viruses in the body.
 
The stages of chronic lymphocytic leukemia (CLL) are:
 
  • Stage 0too many lymphocytes in the blood, but there are no other symptoms of leukemia.
  • Stage Itoo many lymphocytes in the blood and the lymph nodes are larger than normal.
  • Stage II: too many lymphocytes in the blood, the liver or spleen is larger than normal, and the lymph nodes may be larger than normal.
  • Stage IIItoo many lymphocytes in the blood and there are too few red blood cells. The lymph nodes, liver, or spleen may be larger than normal.
  • Stage IVtoo many lymphocytes in the blood and too few platelets. The lymph nodes, liver, or spleen may be larger than normal and there may be too few red blood cells. 
 
 
 
 
Risk factors
 
  • Older age
  • Family history of leukemia or other cancers of the blood/bone marrow
  • Race. Caucasians are more commonly diagnosed with CLL.
  • Gender. Men are more likely to develop CLL than women.
  • Certain inherited syndromes may increase the risk of CLL in patients, including those who have Down syndrome, or blood disorders such as polycythemia vera
  • Exposure to chemicals. Certain herbicides and insecticides have been linked to an increased risk of CLL.
 
Diagnosis
After a patient’s medical history and physical exam, a doctor may order additional tests to confirm the diagnosis of chronic lymphocytic leukemia (CLL). These tests include:
 
  • Blood tests can reveal the number of different types of blood cells, including the number of lymphocytes. 
  • Bone marrow aspiration and/or biopsy are done by taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (core biopsy) and are examined for the number, size, and maturity of blood cells and abnormal cells. 
  • Flow cytometry and immunohistochemistry tests helps determine whether an increased number of lymphocytes are due to CLL, a different blood disorder, or your body's reaction to another process such as infection.
  • Cytogenetic tests look for changes in the chromosomes of cells from samples of blood, bone marrow, or lymph nodes. 
  • Fluorescent in situ hybridization (FISH) uses special fluorescent dyes to look for changes in chromosomes that are found in blood or bone marrow samples.  
 
 
Treatment
Treatment decisions are based on the stage of CLL a patient has and is aimed to decrease signs and symptoms to help one live longer. Treatment options may include chemotherapy, radiation therapy, surgery or a combination of these.
 
 
 
# CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) BY THE NUMBERS #
  • CLL is the second most common type of leukemia in adults.
  • Over 15,700 patients are diagnosed with CLL in the United States each year.
  • About 4,500 patients die each year from CLL in the United States.
 
about Chronic lymphocytic leukemia (CLL)
 
 

Sources
  • "Chronic Lymphocytic Leukemia Symptoms & Treatment." Cleveland Clinic. Cleveland Clinic, 29 Oct. 2009. Web. 30 June 2017.
  • "Chronic Lymphocytic Leukemia." Mayo Clinic. Mayo Foundation for Medical Education and Research, 19 Apr. 2016. Web. 30 June 2017.
  • "Chronic Lymphocytic Leukemia (CLL): Diagnosis." Chronic Lymphocytic Leukemia (CLL): Diagnosis | Johns Hopkins Medicine Health Library. Johns Hopkins Health System, n.d. Web. 30 June 2017.
  • "Leukemia." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 07 June 2017. Web. 30 June 2017.  

 

Hematology is a branch of medicine that is concerned with the diagnosis and treatment of these blood disorders. If you think you may be suffering from a blood disorder, it is important you visit your primary care physician. If they find any abnormalities in your blood work, they may refer you to a hematologist. Finding the right doctor is a very important process. Treatment for blood disorders can be lengthy, which is why it is a good idea to make sure you have a strong relationship with your hematologist from the beginning. Here are three tips for choosing a hematologist:
 
\blood disorders infographic - about CLL

 

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