Chronic Lymphocytic Leukemia

WHAT YOU SHOULD KNOW:

  • Chronic lymphocytic leukemia (CLL) is cancer in your blood and bone marrow. Bone marrow is the soft, spongy tissue inside your bone. Your bone marrow makes the cells found in your blood, including your white blood cells. Lymphocytes are a type of white blood cell that attack infections from germs called bacteria or viruses. With CLL, bone marrow makes damaged lymphocytes that may build up in your lymph nodes, liver, and spleen. Your lymph nodes are small organs made of tissue that fight infection. Your liver and spleen are organs located in your upper abdomen (stomach). Your bone marrow may also stop making enough other cells, such as platelets and red blood cells.

  • Caregivers do not know what causes CLL. Your caregiver uses blood tests and a physical exam to diagnose your CLL. You may have symptoms such as bleeding, bruising, and fever (high body temperature). Your lymph nodes, spleen, and liver may become larger. You may need cancer treatments, including chemotherapy, radiation therapy, or a cell transplant. There is no cure for CLL. Treatment may help your blood cells become normal again and decrease your risk of bleeding or getting infections. Treatment may also help decrease the size of your liver or spleen.

INSTRUCTIONS:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists.

  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.

  • Antinausea medicine: This medicine may be given to calm your stomach and prevent vomiting.

  • Pain medicine: You may need medicine to take away or decrease pain.

    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

  • Steroids: This medicine may be given to decrease inflammation.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Your caregiver will check the size of your lymph nodes, spleen, and liver. Tell your caregiver about any new symptoms or side effects from your treatment. You may have blood tests to see how well your treatment is working. A sample of your bone marrow may be sent to a lab for testing. You may also have imaging tests, such as a chest x-ray or an ultrasound. Ask your caregiver for more information about these or other tests that you may need.
  • After treatment, your caregiver will see how your body is responding. You may have many different responses. These responses may stay the same (a stable response) or get better or worse. Your caregiver will use your response to help him decide whether you need more treatment, such as chemotherapy. You may respond to treatment in any of the following ways:

    • Complete remission: If you have a complete remission (response) after treatment, your blood tests become normal again. Your spleen, liver, or lymph nodes will be normal sized. You will not have symptoms such as fatigue or sweating.

    • Partial remission: You may have a partial response to treatment. During partial remission, you may still have signs and symptoms of CLL. Your body will have fewer damaged lymphocytes than before treatment. Your body may also produce enough red blood cells. Your caregiver may not be able to feel large lymph nodes under your skin. Your liver and spleen may become smaller.

    • Minimal residual disease: You may have minimal residual disease. This means that you have very few cancer cells left in your body.

    • Progressive disease: If you have progressive disease, your CLL is getting worse. Your body may not be making enough red blood cells or platelets. Your lymph nodes, spleen, and liver may get larger.

    • Relapse: You may relapse after having a complete or partial response to treatment. This means that you have signs and symptoms of progressive disease. Your blood tests may become abnormal again. Your lymph nodes, spleen, and liver may get larger.

    • Refractory disease: Refractory disease means that you do not get better with treatment. You may need other treatments, such as a stem cell transplant.

Chemotherapy:

This medicine, often called chemo, is used to treat cancer. Chemotherapy may be used to shrink lymph nodes that have cancer in them. Many different chemotherapy medicines are used to treat cancer. You may need blood tests often. These blood tests show how your body is doing and how much chemotherapy is needed. Chemotherapy can have many side effects. Caregivers will watch you closely and will work with you to decrease side effects. Chemotherapy may help you feel better or live longer.

Radiation therapy:

This is a treatment using x-rays or gamma rays to treat cancer. Radiation kills cancer and keeps the cancer from spreading. It also keeps cancer cells from dividing into new cells, which is one way cancer spreads. Lymph nodes with cancer are also treated with radiation. It may also be given with chemotherapy. Radiation may shrink your lymph nodes and spleen.

Eating well with cancer and cancer treatment:

Good nutrition can:

  • help you feel better during treatment and decrease treatment side effects

  • decrease your risk of infection

  • help you have more energy and feel stronger

  • help you maintain a healthy weight and heal faster
Eat a variety of healthy foods to get the protein, carbohydrates, and other nutrients that your body needs. You may need to change the foods you eat depending on your treatments and side effects. You also may need to eat more calories than usual. Work with a dietitian to plan the best meals and snacks for you. Ask if you should add vitamins to your diet.

Do not drink alcohol:

Some people should not drink alcohol. These people include those with certain medical conditions or who take medicine that interacts with alcohol. Alcohol includes beer, wine, and liquor. Tell your caregiver if you drink alcohol. Ask him to help you stop drinking.

Do not smoke:

Smoking causes lung cancer and other long-term lung diseases. It increases your risk of many cancer types. Smoking also increases your risk of blood vessel disease, heart attack, and vision disorders. Not smoking may help prevent such symptoms as headaches and dizziness for yourself and those around you. Smokers have shorter lifespans than nonsmokers.

CONTACT A CAREGIVER IF:

  • You have a fever (high body temperature).

  • You have new bruises or bruises that are getting bigger.

  • You think you have an infection, such as a cough, cold, or flu.

  • Your lymph nodes become painful or more swollen.

  • You are losing weight without trying.

  • You have a new rash.

  • You feel depressed.

  • You have chest pain or trouble breathing that is getting worse over time.

  • You have questions or concerns about your condition, treatment, or care.

SEEK CARE IMMEDIATELY IF:

  • You have bleeding that does not stop.

  • You have a fast heartbeat.

  • You have very bad pain in your abdomen.

  • You suddenly feel lightheaded and have trouble breathing.

  • You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Chronic Lymphocytic Leukemia (Aftercare Instructions)

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