Chronic lymphoblastic leukemia (CLL) is a common blood and bone marrow disease seen in adults. It is very rare for this disorder to affect children or adults younger than their mid-forties. Older white males are at higher risk of CLL as well as those with Eastern European Jewish descent.

According to the National Cancer Institute, CLL occurs when too many bone marrow stem cells are replaced by abnormal lymphocytes, leading to the blood containing too many CLL cells and not enough normal blood cells. The leukemia cells lack the ability to fight infection and, as they continue to divide, they crowd out healthy white blood cells, red blood cells, and platelets.

Signs and Symptoms

Generally, CLL is a slow-growing disease, and doesn’t produce specific symptoms. It is often discovered upon a routine blood workup. However, there are a handful of signs that are indicative of the presence of CLL. These include swelling around the neck, stomach, underarm, or lymph nodes, feeling exhausted on a regular basis, pain below the ribs, infection, fever, night sweats, and weight loss.

Diagnosis

There are a number of diagnostic tests that are performed to determine whether a person has CLL. First, a physical exam and history is taken to see if there are any obvious signs.

Other procedures include a complete blood count, immunophenotyping, flow cytometry, fluorescence in situ hybridization (FISH), and bone marrow aspiration and biopsy. Immunophenotyping is a test where the antigens and markers of a blood or bone marrow cell are examined to find whether they are myeloid cells or lymphocytes.

Flow cytometry counts the number of cells in a sampling, analyzes the size and shape differences of certain cells, and determines if any tumor markers subsist. FISH is a laboratory test in which technicians examine the genes and chromosomes of particular cells and tissues.

Treatment

In treating CLL, it is important to consider the stage of cancer as well as the symptoms that are apparent, according to the Mayo Clinic. In the earliest stages of CLL, treatment may not be necessary and doctors tend to wait to see the condition progress before beginning treatment. Blood tests are taken every few months during this process. This course of action is pursued because early treatment has not been shown to improve lifespan in patients with CLL.

When this cancer has progressed, some common treatments include chemotherapy, targeted drug therapy, and bone marrow stem cell transplant. In chemotherapy, you may be given one single drug or a combination of medications. Targeted therapy drugs used to treat CLL are usually alemtuzumab (Campath), rituximab (Rituxan), and ofatumumab (Arzerra).

If chemotherapy or targeted drug therapy does not work and the CLL becomes more aggressive, bone marrow stem cell transplants may be the best curative treatment option. Throughout this cancer journey, doctors also perform cancer screenings to evaluate likelihood of other cancers, vaccinate patients from infection, and monitor their health.

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Categories: Oncology

Tags: Chronic lymphoblastic leukemia (CLL)