Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia is a generalized, progressive disease marked by an uncontrollable spread of abnormal, small lymphocytes in lymphoid tissue, blood, and bone marrow. When these cells infiltrate bone marrow, lymphoid tissue, and organ systems, clinical signs begin to appear.

Ninety percent of people who develop CLL are over age 50. It is more common in men than women. According to the American Cancer Society, chronic lymphocytic leukemia accounts for almost one-third of new leukemia cases annually.

Causes

Although the cause of the disease is unknown, researchers suspect hereditary factors because a higher incidence has been recorded within families. Undefined chromosomal abnormalities and certain immunologic defects, such as ataxia telangiectasia or acquired agammaglobulinemia, are also suspected. The disease doesn't seem to result from radiation exposure.

Signs and Symptoms

Early in the disease, there may be no noticeable symptoms. The following are the most common symptoms of chronic lymphocytic leukemia. However, each individual may experience symptoms differently. Symptoms may include:

• persistent weakness
• swollen lymph nodes
• enlarged spleen
• enlarged liver
• anemia

The symptoms of chronic lymphocytic leukemia may resemble other blood disorders or medical problems. Always consult your physician for a diagnosis.

Diagnostic tests 

Typically, chronic lymphocytic leukemia is an incidental finding during a routine blood test that reveals numerous abnormal lymphocytes. In the early stages, the patient has a mildly but persistently elevated white blood cell (WBC) count. Granulocytopenia is the rule, although the WBC count climbs as the disease progresses.

Treatment

Systemic chemotherapy includes alkylating agents, usually chlorambucil or cyclophosphamide, and sometimes corticosteroids (prednisone) when autoimmune hemolytic anemia or thrombocytopenia occurs.

When chronic lymphocytic leukemia causes obstruction or organ impairment or enlargement, local radiation therapy can reduce organ size, and splenectomy can help relieve the symptoms. Allopurinol can prevent hyperuricemia, a relatively uncommon finding.

Radiation therapy can help relieve symptoms. It's generally used to treat enlarged lymph nodes, painful bony lesions, or massive splenomegaly.

Prevention

Check with your health care provider before taking other medicines, including nonprescription products or other forms of treatment.

Continue to eat a balanced diet and get regular exercise.

If you have a sore throat or fever, call your health care provider for advice. You may need immediate treatment.

It is important to have regular checkups and to follow your health care provider's advice about how to take care of yourself.

If several family members have had the disease, there is an increased risk of siblings, especially brothers, to have the disease. If you are at increased risk, you should have regular checkups.