Chronic Lymphocytic Leukemia
Chronic Lymphocytic Leukemia: What Is It?
Cancer of the blood and the tissues that form the blood is known as leukemia. Since there are different types of blood cells, there are different types of this cancer. One that affects the lymphocytes is called chronic lymphocytic leukemia (CLL).
The lymphocytes are one of the white blood cell types and CLL affects the B cells. When the B cells are normal, they will fight infections as they flow around your body in the blood. When the B cells become cancerous, they are unable to fight all the infections effectively. As there are more cancerous cells than the healthy ones, it leads to the bone marrow failing.
There is currently no known reason for CLL to appear.
Risk Factors of CLL
Those under 40 will rarely find that they have CLL. This is usually found in people over the age of 70 and those Jewish of Eastern European and Russian descent. More men are affected than women.
The CLL Symptoms
Sometimes the cancer is only discovered when there is a routine blood test and there are no symptoms. Those that do have symptoms, usually have:
- Unexplained weight loss
- Frequent illnesses and infections
- Night sweats
Enlarged lymph nodes, spleen and liver may also be noticed by a doctor when carrying out a physical exam. This is a sign that the cancer has spread. CLL patients may find painful lumps that are often in the neck. They may also feel like their belly is swelling or full.
Staging and Diagnosing CLL
Tests and the diagnosis:
There are a few tests that need to be carried out to official diagnose CLL. Your doctor will likely order:
- A complete blood count (CBC) and a white blood cell differential. This will check the different types of cells within the blood and check the number of them. Those with CLL will usually have more lymphocytes.
- Biopsy of the bone marrow. This involves a needle being placed in the breast or hip bone to get a sample of the marrow.
- Computed tomography (CT) scan to check for any swollen lymph nodes around the abdomen or chest.
- Immunoglobulin tests to make sure there are enough antibodies for fighting infections.
After the diagnosis, your doctor will need to find out how far along the disease is. This is classified by a stage to help determine the type of treatment you need. Your doctor will need to get the specific count of the lymphocytes, check for the enlarged liver, nodes and spleen and check the count of the red blood cells.
There are five stages (0 to IV) with IV being the worst. The stages are grouped into risk levels for treatment. Low risk patients are stage 0; intermediate risk patients are stages I and II; high risk patients are stages III and IV. This is according to the American Cancer Society.
Waiting and watching is the most common treatment for those who are deemed to be low risk. Other treatment options are used for patients who have:
- Recurrent or persistent infections
- Night sweats or fatigue
- Low blood counts
- Lymph nodes that are painful
The most common treatment for others is chemotherapy. Medications are used to kill off the cancerous cells and is given orally or intravenously, depending on the type of medications administered. Where there are painful lymph nodes, it is possible to shrink them with radiation, which helps to relieve some pain. Where there is a low blood count, blood transfusions are often necessary.
Patients who are at a high risk will usually need a peripheral blood stem cell or bone marrow transplant. This involves a donor giving some bone marrow or stem cells and transplanting them into the patient. Family members are the most common donors and help with creating a newer immune system.
There are different factors that affect the rate of survival, including gender, age, the characteristics of the cancerous cells and any abnormalities with the chromosomes. Those diagnosed at the earlier stages of CLL are able to live for long periods of time with about 50% living for over 12 years.
Complications with CLL and Treatment
When using chemotherapy, the immune system is weakened, meaning that patients are more vulnerable to other infections. It is also possible to feel more tired and other cancers may also appear. The treatment is also linked to low blood counts and antibodies levels that are abnormal.
Other chemotherapy side effects are:
- Mouth sores
- Loss of hair
- Nausea or vomiting
- Loss of appetite
You should talk to your doctor about all the side effects to know more about the treatment and any side effects that you do have to determine if other treatment or medical attention is needed.