Chronic Lymphocytic Leukemia

What is chronic lymphocytic leukemia?

Chronic lymphocytic leukemia (CLL) is cancer in your blood and bone marrow. Lymphocytes are a type of white blood cell (WBC) that prevent and fight infections. Your bone marrow makes damaged lymphocytes and your body has trouble fighting infections if you have CLL. It may prevent your bone marrow from making other blood cells and cause bleeding or infections.

What causes CLL?

The cause is unknown. You may be more likely to develop CLL if someone in your family has had it. CLL is also more common in older people. You may be more likely to get CLL if you are male.

What are the signs and symptoms of CLL?

You may have no symptoms during the early stages of CLL. Over time, you may start to have some of the following:

  • Easy bleeding or bruising

  • Frequent illnesses, such as colds, coughs, or the flu

  • Low energy or feeling very tired

  • Fever

  • Weight loss without trying

  • Night sweats

  • Swollen lymph nodes in your neck, armpits, or groin

  • Abdominal swelling, pain, or discomfort

How is CLL diagnosed?

Your caregiver will ask about your symptoms and examine you. He will feel your abdomen to see if your liver or spleen is larger than normal. An enlarged liver or spleen is a sign that your body has too many WBCs. He will check your neck, armpits, and groin for large lymph nodes. You may need the following:

  • Blood tests check if your lymphocytes are normal or damaged. They also count the number of each type of blood cell (RBCs, WBCs, platelets).

  • An ultrasound uses sound waves to show pictures of your organs and tissues on a monitor. Your caregiver may use this test to check the size of your spleen, liver, or lymph nodes.

  • A bone marrow biopsy is a procedure to take a small amount of bone marrow from your hip. This test helps caregivers find out if your bone marrow is making enough healthy blood cells.

How is CLL treated?

Your caregiver will use your blood tests and physical exam to determine if your CLL is early, middle, or late stage. You might not need treatment if you are in an early stage and do not have symptoms. If you do not need treatment, your caregiver will ask you to come back for follow-up visits. These visits will include a physical exam and blood tests. He will check to see if you are still in the same stage. He will also decide whether you should begin treatment. You may need any of the following treatments:

  • Chemotherapy is used to treat cancer by killing tumor cells. Chemotherapy may also be used to shrink lymph nodes that have cancer in them.

  • Biologic therapy for cancer is medicine that helps your body fight growing cancer cells. It may also make cancer cells weaker and easier to kill. You may need this medicine more than once. You may feel like you have the flu during this therapy.

  • Radiation therapy shrinks tumors and kills cancer cells with x-rays or gamma rays. It may be given alone or with chemotherapy to treat cancer.

  • A bone marrow or stem cell transplant is a procedure to put bone marrow or stem cells into your blood through an IV. The stem cells should go to your bone marrow and begin to make new blood cells.

  • Medicines may be given to help treat or prevent infection. Steroids may also be given to help you make healthy red blood cells.

How will I respond to treatment?

You may have stable disease, which means your cancer does not change stages with or without treatment. You may respond one way to treatment and then have a different response later. You may have any of the following:

  • Complete remission after treatment means your blood tests become normal again. Your spleen, liver, or lymph nodes will be normal sized. You will not have symptoms.

  • Partial remission means you may still have signs and symptoms of CLL. Your body will have fewer damaged lymphocytes than before treatment. Your body may produce enough red blood cells. Your liver, spleen, and lymph nodes may become smaller.

  • Minimal residual disease means that you have very few cancer cells left in your body.

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

When should I contact my caregiver?

  • You have a fever.

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

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

  • Your lymph nodes become painful or larger.

  • You are losing weight without trying.

  • You have night sweats.

  • You feel depressed.

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

When should I seek immediate care or call 911?

  • You feel lightheaded, short of breath, and have chest pain.

  • You cough up blood.

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

  • You have bleeding that does not stop.

  • You heartbeat is faster than normal for you.

  • You have severe pain in your abdomen.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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