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Chronic Lymphocytic Leukemia, Ambulatory Care

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. It may prevent your bone marrow from making other blood cells and cause bleeding or infections.

Common symptoms include 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

Call 911 for any of the following:

  • Warm, tender, swollen, red, and painful arm or leg
  • Feeling lightheaded and short of breath, with chest pain
  • Coughing up blood

Seek care immediately for the following:

  • Bleeding that does not stop
  • Faster heartbeat than normal for you
  • Severe pain in your abdomen

Treatment for CLL

will be based on the stage of your CLL. You might not need treatment if you are in an early stage and do not have symptoms. If you do not need treatment, your healthcare provider 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 if you should begin treatment. You may need any of the following:

  • Chemotherapy is used to kill tumor cells or 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 transplant is a procedure to put bone marrow or stem cells into your blood through an IV. The stem cells 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.

Manage your CLL:

  • Prevent infection. Wash your hands often, avoid people who are sick, and clean humidifiers daily. Ask your healthcare provider for more information on preventing infection.
  • Prevent bleeding and bruising. Be careful with sharp or pointed objects, such as knives and toothpicks. Do not play contact sports, such as football. Use a soft toothbrush. Do not floss your teeth while your platelet count is low. Blow your nose gently. Your nose may bleed if you pick it. Do not take NSAIDs or aspirin. NSAIDs and aspirin thin your blood and increase your risk for bleeding.
  • Do not smoke cigarettes or drink alcohol. Alcohol can thin your blood and make it easier to bleed. Smoking increases your risk for new or returning cancer. Smoking can also delay healing after treatment. Ask your healthcare provider for information if you currently smoke or drink and need help quitting.
  • Drink liquids as directed. You may need to drink extra liquids to prevent dehydration, especially if you are vomiting or have diarrhea from cancer treatments. Ask how much liquid you need each day and which liquids are best for you.
  • Exercise as directed. CLL or its treatment may make you feel tired. Exercise can help you have more energy.
  • Eat healthy foods. Healthy foods may help you feel better and have more energy. If you have trouble swallowing, you may be given foods that are soft or in liquid form. Ask about any extra nutrition you may need, such as nutrition shakes or vitamins. Tell your healthcare provider if you have problems eating, or if you are nauseated.

Follow up with your healthcare provider as directed:

You will need to see your oncologist for ongoing treatment. Write down your questions so you remember to ask them during your visits.

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.

© 2016 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.

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.