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Chronic lymphocytic leukemia (CLL): Causes, Types, Symptoms, Diagnosis and Treatment

What is Chronic Lymphocytic Leukemia (CLL)?

Leukemia is a cancer that starts in the blood-forming cells of the bone marrow. When one of these cells changes and becomes a leukemia cell, it no longer matures as it should and grows out of control. It often divides to make new cells faster than normal. Leukemia cells also don't die when they should. This allows them to accumulate in the bone marrow and crowd out normal cells.Eventually, the leukemia cells break out of the bone marrow and enter the bloodstream. This increases the number of white blood cells in the blood. Once leukemia cells are in the blood, they can spread to other organs, where they can prevent other cells in the body from functioning normally.

Leukemia is different from other types of cancer, which start in organs such as the lungs, colon or breast and then spread to the bone marrow. Cancer that starts elsewhere and then spreads to the bone marrow is not leukemia.Knowing the exact type of leukemia helps doctors better predict each patient's prognosis and select the best treatment.

In chronic leukemia,  cells can partially mature  (and more closely resemble normal white blood cells). but not completely. These cells may appear normal, but they are not. They  don't usually fight infection as well as normal white blood cells.Leukemia cells survive longer than normal cells and accumulate, crowding out normal cells in the bone marrow. Chronic leukemia can take a long time to cause problems, and most people can live with it for many years. However, chronic leukemias tend to be more difficult to cure than acute leukemias.

Leukemia is either myeloid or lymphocytic, depending on which bone marrow cells the cancer starts in.

Lymphocytic leukemias (also known as lymphoid or lymphoblastic leukemia) begin in  cells that develop into lymphocytes.Lymphomas are also cancers that start in these cells. The main difference between lymphocytic leukemia and lymphoma is that in leukemia, the cancer cells are mainly located in the bone marrow and blood, while in lymphoma, they are more likely to be located in the lymph nodes and other tissues.

 

What is Chronic Lymphocytic Leukemia (CLL)

 

Explanation of medical terms and concept (CLL)

Chronic lymphocytic leukemia (CLL)may be a kind of cancer of the blood and bone marrow — the spongy tissue within bones wherever blood cells are made.

The term "chronic" in chronic lymphocytic leukemia comes from the very fact that this leukemia usually progresses additional slowly than different forms of leukemia. The term "lymphocytic" in chronic lymphocytic leukemia comes from the cells full of the malady — a bunch of white blood cells known as lymphocytes, that help your body fight infection.

Chronic lymphocytic leukemia most typically affects older adults. There are treatments to assist management of the disease.

Chronic lymphocytic leukemia (CLL) is a type of cancer that starts in cells called lymphocytes Lymphocytes are a type of white blood cell that fight infection Normally the body has too few lymphocytes to be visible or felt and no symptoms of the disease develop However CLL starts when lymphocytes begin to grow and divide out of control The affected cells accumulate and form knots inside the small channels that carry blood throughout the body These clumps called granulomas can interfere with normal blood flow or cause infections as they break down over time They are also associated with swelling and pain in.

treatment options There are several treatments available for chronic lymphocytic leukemia (CLL) Generally these include medications that suppress the overactive white blood cells that contribute to the cancer These include a class of drugs called monoclonal antibodies and another type of drug called tyrosine kinase inhibitors In some cases chemotherapy is used to treat CLL When this is necessary most experts recommend using rituximab combined with cyclophosphamide in order to reduce side effects The same treatment may be recommended if relapsed disease occurs after other therapies have cured it initially More recently anti-CD20 monoc.

Key Points

  • Chronic lymphocytic leukemia is a type of cancer that results from the bone marrow producing too many lymphocytes.

  • Leukemia may affect the red blood cells, white blood cells, and platelets.

  • CLL is a type of leukemia that often causes swollen lymph nodes and feeling tired.

  • Tests that examine the blood are used to diagnose leukemia.

  • The treatment options and prognosis (chance of recovery) vary depending on certain factors.

When to see a doctor

Make an appointment with your doctor if you have any persistent signs and symptoms that worry you.

Chronic lymphocytic leukemia is a type of cancer in which the bone marrow produces too many lymphocytes.

Chronic lymphocytic leukemia (also called CLL) is a cancer that usually progresses slowly. It is one of the most common types of leukemia in adults. It often occurs during middle-age years; it rarely occurs in children.

The bone is made of compact bone, spongy bone, and bone marrow. Compact bone is found on the outside of bones, and spongy bone is found near the ends of bones. Bone marrow is in the center of most bones and has many blood vessels. Red marrow contains blood stem cells that can become red blood cells, white blood cells, or platelets. Yellow marrow is mostly made of fat.

Leukemia may affect red blood cells, white blood cells, and platelets.

Normally, the bone marrow makes blood stem cells that can become either immature blood cells or more mature cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell.

Blood cells develop from stem cells. A myeloid stem cell turns into one of three types of mature blood cells- red blood cells, white blood cells, or platelets.

  • Red blood cells are responsible for transporting oxygen and other substances to all parts of the body.

  • White blood cells are responsible for fighting infection and disease.

  • Blood clots to stop the flow of blood.

A lymphoid stem cell turns into a lymphoblast cell, and then one of three types of lymphocytes: white blood cells.

  • Antibodies are cells that help fight infection.

  • T lymphocytes and B lymphocytes help one another make antibodies that help fight infection.

  • Cancer cells and viruses are attacked by natural killer cells.

Blood cell development. A blood stem cell goes through several steps to become a red blood cell, white blood cell, or platelet.

In CLL, too many blood stem cells become abnormal lymphocytes. These abnormal lymphocytes are not able to fight infection well. They may also be called leukemia cells. As the number of leukemia cells increases in the blood and bone marrow, there is less room for healthy white blood cells. Blood cells are red blood cells and platelets. This may lead to infection, anemia, and easy bleeding.

This summary is about leukemia.For more information about other types of leukemia, see the following PDQ summaries:

Causes Chronic lymphocytic leukemia (CLL)

Chronic lymphocytic leukemia (CLL) often causes enlarged lymph nodes and a feeling of tiredness.

At first, CLL may not cause any signs or symptoms. Later, signs and symptoms may occur. Talk to your doctor if you have any of the following: -Any changes in your blood test results -New symptoms

  • Swollen lymph nodes in the neck, underarm, stomach, or groin can be painless.

  • Weakness or feeling tired.

  • This passage is describing how to determine if someone has pain or a feeling of fullness below the ribs.

  • A fever and infection can both cause body aches.

  • Easy bruising or bleeding.

  • Petechiae (small, flat, dark-red spots on the skin caused by bleeding).

  • Weight loss for no known reason.

  • Drenching night sweats.

Tests that look at the blood are used to diagnose chronic lymphocytic leukemia.

The following tests and procedures may be used to determine the quality of the olive oil: -Tests to determine if the oil is fresh -Tests to determine if the oil is of high quality

  • A physical exam and health history are important parts of staying healthy.A physical exam of the body is conducted to check general signs of health, such as checking for enlarged lymph nodes or any other unusual symptoms. The patient's medical history and past illnesses and treatments will also be taken into account.

  • A CBC (complete blood count) is a test that looks at the number and types of blood cells in your blood. This can also be done with a differential, which is a test that looks at the number and types of infections in your blood.A blood test is performed to check for the following:

    • The number of red blood cells and platelets is important.

    • How many white blood cells a person has depends on their genetics.

    • The amount of red blood cells with hemoglobin.

    • The portion of the blood sample that is made up of red blood cells.

    • A blood sample is collected by inserting a needle into a vein and allowing the blood to flow into a tube. The red blood cells, white blood cells, and platelets are counted in the sample. The CBC is used to check for a variety of health issues and to track changes over time. The weather conditions are important.

  •  

  • Blood chemistry studiesA test to measure the amounts of certain substances released into the blood is done. If the amount of a substance is unusual, it may be a sign of disease.

  • Lactate dehydrogenase testingLactate dehydrogenase is a laboratory test used to determine if there is tissue damage or disease. An increase in the amount of lactate dehydrogenase in the blood may be a sign of this.

  • Beta-2-microglobulin testing A laboratory test can indicate whether someone has high levels of beta-2-microglobulin in their blood or urine. This protein is present on the surface of many cells, including lymphocytes and in small amounts in the blood and urine. If someone has an increase in beta-2-microglobulin levels, this may be a sign of certain diseases, such as some types of cancer. Myeloma or lymphoma are diseases.

  • Flow cytometry A laboratory test that detects the number of cells, the percentage of live cells, and certain characteristics of cells from a sample. For example, the test might measure the size, shape, and presence of tumor markers on the cell surface. The cells from a sample from a patient's blood, bone marrow, or other tissues may be tested. A fluorescent dye is placed in a fluid, and then other tissues are stained with it. The results of the test are based on how the cells that were stained react to a beam of light. This test is used to diagnose and manage certain conditions. Cancers such as leukemia and lymphoma are common among people who have been exposed to environmental toxins.

  • FISH (fluorescence in situ hybridization) This is a picture of a fish that has been labeled with a fluorescent dye so that its cells can be seen under a microscope.A laboratory test is used to look at and count genes or chromosomes in cells and tissues.Small pieces of DNA that contain fluorescent dyes are created in a laboratory. These pieces of DNA are then added to a sample of the patient's cells or tissues. When these dyed pieces of DNA attach to certain genes or areas on chromosomes, this tells scientists what the patient’s genetic makeup is.The FISH test is used to diagnose cancer and to help plan treatment. When the sample is viewed under a fluorescent microscope, it will light up brightly.

  • Gene mutation testingA test that looks at changes in the TP53 or IgVH genes can help to determine the patient's prognosis.

  • Serum immunoglobulin testingA laboratory test will measure specific types of immunoglobulins in the blood. This can help diagnose cancer or determine how well treatment is working or if cancer has returned.

  • Test for the hepatitis B and hepatitis C viruses.A test to check for hepatitis B or hepatitis C virus is conducted in the blood. Infection with one of these viruses causes liver inflammation.

  • HIV testingA test to check if you have HIV is called an HIV antibody test. This test checks for antibodies against HIV in a sample of blood, urine, or fluid from the mouth. If you have this virus, your immune system will make these antibodies.

There are many factors that affect the treatment options and prognosis (chance of recovery).

There are many treatment options that depend on the following:

  • The number of red blood cells, white blood cells, and platelets in your blood.

  • Are the liver and spleen larger than normal?

  • The age and health of the patient at the time of diagnosis affects how the patient will be treated.

  • If there are any signs or symptoms such as fever, chills, or weight loss, it is important to check them out.

  • The response to initial treatment.

  • Has the CALL (chronic lymphocytic leukemia) returned?

The prognosis depends on the following:

  • What changes might occur in genes due to TP53 or IgVH mutations?

  • Can lymphocytes be found throughout the bone marrow?

  • If the red blood cell and platelet counts are low, it means there may be a problem with the blood.

  • If the white blood cell count is increasing quickly, that means there may be an infection.

  • The stage of the cancer.

  • The results of certain blood tests can be determined by beta-2 microglobulin.

  • The patient's age and general health are important factors in determining their treatment plan.

  • How quickly and how much the leukemia cell count drops during treatment.

  • Is CLL getting better or has it recurred (come back)?

  • Whether the CLL progresses to lymphoma or becomes prolymphocytic leukemia.

  • Will the patient get cancer of a different type after being diagnosed with CLL?

Chronic lymphocytic leukemia is a type of cancer that affects the blood.Lymphoma is a disease that affects the lymph nodes.

Key Points

  • After being diagnosed with chronic lymphocytic leukemia, tests are done to see if the cancer has spread.

  • Chronic lymphocytic leukemia is treated with the following steps:

    • Stage 0

    • Stage I

    • Stage II

    • Stage III

    • Stage IV

  • Chronic lymphocytic leukemia is a type of leukemia that can have no symptoms, be asymptomatic, or progress slowly but steadily.

Risk factors Chronic lymphocytic leukemia (CLL)

Factors that may increase the risk of chronic lymphocytic leukemia include:

  • Your age. This disease occurs most often in older adults.

  • Your race. White people are more likely to develop chronic lymphocytic leukemia than are people of other races.

  • Family history of blood and bone marrow cancers. A family history of chronic lymphocytic leukemia or other blood and bone marrow cancers may increase your risk.

  • Exposure to chemicals. Certain herbicides Associate in Nursing insecticides, together with herbicide used throughout the Vietnam War, are coupled to an inflated risk of chronic leukocyte leukemia

  • A condition that causes excess lymphocytes. Monoclonal B-cell blood disorder (MBL) causes associate enlarged variety of 1 form of leukocyte (B cells) within the blood. For attiny low number of individuals with MBL, the condition may turn into chronic white blood cell leukemia. If you have got MBL and even have a case history of chronic lymphocytic leukemia, you will have the next risk of developing cancer.

Complications

Chronic lymphocytic leukemia may cause complications such as:

  • Frequent infections. If you have got chronic white blood corpuscle leukemia, you'll expertise frequent infections that may be serious. Generally infections happen as a result of your blood not having enough germ-fighting antibodies (immunoglobulins). Your doctor would possibly suggest regular Ig infusions.

  • A switch to a more aggressive form of cancer. A small range of individuals with chronic leukemia might develop a lot of aggressive kind of cancer known as diffuse massive B-cell lymphoma. Doctors generally sit down with this as Richter' syndrome.

  • Increased risk of other cancers. People with chronic lymphocytic leukemia have an increased risk of other types of cancer, including skin cancer and cancers of the lung and the digestive tract.

  • Immune system problems. A small range of individuals with chronic cancer of the blood could develop associate degree system drawback that causes the disease-fighting cells of the immune system to erroneously attack the red blood cells (autoimmune lysis anemia) or the platelets (autoimmune thrombocytopenia).

Diagnosis Chronic lymphocytic leukemia (CLL)

When someone has been diagnosed with chronic lymphocytic leukemia, tests are done to see if the cancer has spread.

Staging is the process used to determine how far the cancer has spread. In chronic lymphocytic leukemia (CLL), leukemia cells may spread from the blood and bone marrow to other parts of the body, such as the lymph nodes, liver, and spleen. It is important to know whether the cancer cells have spread. Select the best treatment plan by spreading the solution.

Cancer can be spread through the body in different ways. Tests may be used to determine how far it has spread.

  • Chest x-rayAn x-ray of the organs and bones inside the chest takes pictures of areas inside the body.

  • CT scan (CAT scan) A procedure that makes pictures of organs inside the body from different angles using a computer and an x-ray machine. If dye is injected into a vein, it will show up in the pictures taken during the procedure. This test makes tissues more visible. It is used in patients with many swollen lymph nodes throughout the body. This procedure is also called computed tomography, or computerized axial tomography. If a PET-CT scan is not available, a CT scan may be done alone.

  • PET-CT scan A procedure that combines pictures from a positron emission tomography (PET) and computed tomography (CT) scans. The PET scan and CT scan pictures are combined to create a more detailed picture than either test could produce on its own. A PET scan is a procedure that uses radioactive sugar to find tumor cells in the body. A small amount of radioactive sugar is injected into a vein. The PET scanner rotates around the body and makes a picture of where the sugar is being used in the body. Tumor cells show up brighter in the image. Doctors use pictures to help them understand a patient's illness because the cells in a picture are more active and take up more glucose than normal cells do. This test is used to check whether CLL (a type of lymphoma) has become an aggressive form.

Chronic lymphocytic leukemia (CLL) is treated in the following way:

Stage 0

Chronic lymphocytic leukemia (CLL) has a high number of lymphocytes in the blood, but there are no other signs or symptoms of leukemia. In stage 0 CLL, the cancer is slow-growing.

Stage I

Chronic lymphocytic leukemia is a type of leukemia in which there are too many lymphocytes in the blood and the lymph nodes are larger than normal.

Stage II

Chronic lymphocytic leukemia is a type of leukemia in which there are too many lymphocytes in the blood. The liver or spleen may be larger than normal, and the lymph nodes may be larger than normal.

Stage III

Chronic lymphocytic leukemia has progressed to stage III. There are too many lymphocytes in the blood and too few red blood cells. The lymph nodes may be larger than normal, or there may be signs of an enlarged liver or spleen.

Stage IV

Chronic lymphocytic leukemia (CLL) is a type of leukemia in which there are too many lymphocytes in the blood. This may be noticed by the presence of enlarged lymph nodes or liver or spleen size that is above normal. There may also be a decreased number of red blood cells.

Chronic lymphocytic leukemia is a disease that can have various symptoms, ranging from asymptomatic to symptomatic or progressive to refractory or recurrent.

  • There is no indication that the leukemia is causing any symptoms.

  • If you have leukemia, there are usually serious changes in your blood counts or other symptoms.

  • Relapsed leukemia: The cancer has come back after a period of time in which it could not be detected.

  • This leukemia does not respond well to treatment.

Treatment  Chronic lymphocytic leukemia (CLL)

Key Points

  • There are different ways to treat patients with chronic lymphocytic leukemia.

  • Six types of treatment are used:

    • Watchful waiting

    • Targeted therapy

    • Chemotherapy

    • Radiation therapy

    • Immunotherapy

    • Chemotherapy may involve using bone marrow or peripheral stem cells.

  • Some new treatments are being tested in clinical trials.

  • Chronic lymphocytic leukemia (CLL) treatment can result in side effects.

  • Some patients may want to take part in a clinical trial.

  • Patients can enter clinical trials before, during, or after starting their cancer treatment.

  • Follow-up tests may be needed.

Chronic lymphocytic leukemia is treated in a variety of ways.

There are many different treatments available for people with chronic lymphocytic leukemia. Some of these treatments are standard, while others are being tested in clinical trials in order to improve or obtain new treatments. New treatments for cancer patients are being studied in clinical trials. When clinical trials show that a new treatment is better than the standard treatment, that new treatment may become the standard treatment. If you or a loved one is considering taking part in a clinical trial, be sure to ask about eligibility first. Some clinical trials are open to only certain groups of people. People who have not started treatment are patients.

Six types of treatment are used:

Watchful waiting

Observing a patient is closely monitoring their condition without giving them any treatment until signs or symptoms appear or change. This is called watchful waiting, and it's used to treat asymptomatic and symptomatic or progressive leukemia.

Targeted therapy

Targeted therapies are types of treatment that use drugs or other substances to identify and attack specific cancer cells. These treatments usually cause less harm to normal cells than chemotherapy or radiation therapy do. Different types of targeted therapies are used to treat chronic lymphocytic leukemia (CLL):

  • TKI therapy is a treatment that uses medications to stop the growth of cancer cells.This treatment prevents the enzyme tyrosine kinase from working, which causes stem cells to develop into fewer white blood cells than the body needs. Ibrutinib, acalabrutinib, idelalisib, and duvelisib are TKIs used to treat CLL symptoms or progression.

  • BCL2 inhibitor therapy:This treatment blocks a protein called BCL2 which is found on some leukemia cells. This may kill leukemia cells and make them more susceptible to other anticancer drugs. Venetoclax is a type of BCL2 therapy used to treat symptomatic or progressive recurrent or refractory leukemia.

  • Monoclonal antibody therapy is a treatment that uses antibodies from a single cell.Monoclonal antibodies are proteins created in the laboratory to fight many diseases, including cancer. When these antibodies attach to a specific target on cancer cells or other cells that help cancer grow, they can then kill the cancer cells. Cells block their growth or prevent them from spreading.Monoclonal antibodies are injected into the body. They may be used alone or in combination with drugs to destroy cancer cells. Rituximab, obinutuzumab, and ofatumumab are used to treat cancer. This describes a case of leukemia in which the disease is still active and/or is progressing.
    Alemtuzumab has been studied for the treatment of leukemia. Studies showed that it did not help patients live longer.
    Monoclonal antibodies such as trastuzumab and pembrolizumab target molecules cancer cells need in order to grow. When these antibodies are administered, they block these molecules, which helps the body's immune system destroy cancer cells. Rituximab also delivers harmful substances to cancer cells.

See Drugs Approved for Chronic Lymphocytic Leukemia for more information about the drugs.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells. These drugs can be taken by mouth or injected into a vein or muscle, and they can reach cancer cells throughout the body. Combination chemotherapy is a treatment that uses more than one anticancer drug.

See Drugs Approved for Chronic Lymphocytic Leukemia for more information about the drugs.

Radiation therapy

Cancer treatment using radiation is a way to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer. The spleen is an organ in the body that can be treated to reduce pain from swollen lymph nodes or spleen.

Immunotherapy

Immunotherapy is a way to use the patient's immune system to fight cancer. Substances made by the body or created in a laboratory are put into the body to boost its natural defenses against cancer. This cancer treatment is a type of biological therapy.

  • An immunomodulating agent is a substance that alters the immune system.Lenalidomide helps stimulate T cells to kill leukemia cells. It may be used alone or in combination with rituximab in patients with symptomatic or progressive recurrent or refractory CLL.

  • CAR T-cell therapy:This treatment changes the patient's T cells so they will attack proteins on the surface of cancer cells. T cells are taken from the patient and special receptors are added to their surface in a laboratory. These changed cells are called "chimeric antigen" CAR T cells are grown in a laboratory and given to the patient intravenously. The CAR T cells multiply in the patient's blood and target cancer cells. CAR T-cell therapy is being studied as a treatment for recurrent or refractory CLL.Treatment with CAR T-cells involves modifying a patient's T cells so that they will bind to cancer cells and kill them. Blood drawn from a vein in the patient's arm flows through a tube to an apheresis machine, which removes the cells. The white blood cells including T cells fight the infection. Then a gene for a special receptor called a chimeric antigen receptor (CAR) is inserted into the T cells in the laboratory. Millions of the CAR T cells are grown in the laboratory and then given to the patient. The T cells that have been modified with the CAR gene will attack the infection. The CAR T cells are able to bind to the cancer cells and kill them.

If I have chemotherapy or a stem cell transplant, it means that I will need to take medicine regularly for a while.

Cancer treatment kills cancer cells while also damaging healthy cells. A bone marrow or peripheral stem cell transplant can replace the destroyed blood-forming cells. When stem cells are removed from the blood or bone, this is called a stem cell transplant. Stem cells from the patient or a donor are frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and given back to the patient through an infusion. The reinfused stem cells grow into new blood cells and restore the body's natural supply.

Clinical trials are testing new treatments.

Clinical trials information is available from the National Cancer Institute website.

Chronic lymphocytic leukemia (CLL)—a type of blood cancer—may cause side effects.

If you have questions about side effects of cancer treatment, please visit our Side Effects page.

Some patients may want to consider participating in a clinical trial.

Some people may choose to take part in a clinical trial if they are being treated for cancer. Clinical trials are part of the cancer research process. They are done to see if new cancer treatments are safe and more effective than the standard treatment.

Some of the current treatments for cancer were developed through earlier clinical trials. Patients who take part in these trials may receive the standard treatment or be among the first to receive a new treatment.

Clinical trials are a way for patients to help improve the way cancer is treated in the future. Even if trials don't lead to any new treatments, they often answer important questions and help research move forward.

Patients can enter clinical trials at any point before, during, or after starting their cancer treatment.

Some clinical trials are only for patients who have not yet received treatment. Other trials test new ways to treat cancer or reduce the side effects of cancer treatments. There are also clinical trials that test whether stopping cancer from recurring or reducing the side effects of treatment is effective.

Clinical trials are happening in many different parts of the country. Information about clinical trials that have been supported by the National Cancer Institute can be found on the NCI's clinical trials search webpage. Clinical trials that have been supported by other organizations can be found on the ClinicalTrials.gov website.

Follow-up tests may be needed.

Some of the tests that were done to diagnose the cancer or to determine its stage may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue treatment or stop it may be based on the results of these tests.

After treatment has ended, some tests will still be done from time to time. The results of these tests can show if your condition has changed or if the cancer has come back. These tests are sometimes called follow-up tests or check-ups.

About This PDQ Summary

About PDQ

The PDQ database is a compilation of information about cancer prevention, detection, genetics, treatment, and supportive care. This passage has information about medicine. The professional version has detailed information written in technical language. The patient version is written in easy-to-understand nontechnical language. Both versions have accurate and up-to-date cancer information. There are also Spanish translations of this article.

The PDQ summaries are based on an independent review of the medical literature. They are not official statements from the NCI or NIH.

Purpose of This Summary

This PDQ cancer information summary is meant to help patients and their families with current information about the treatment of chronic lymphocytic leukemia. It is not a formal guide for health care decisions.

Reviewers and Updates

The PDQ cancer information summaries are written by editorial boards of experts in cancer treatment. These summaries are updated regularly as new information is learned. The date on each summary is indicated. This is the latest date.

This patient summary was taken from a version of the health professional's report that is regularly reviewed and updated.

Clinical Trial Information

A clinical trial is a study that tries to answer a scientific question such as whether one treatment is better than another. Clinical trials are based on past studies and what has been learned in the laboratory. Each trial tries to find new and better ways to help cancer patients. Clinical trials are conducted to gather information about the effects of a new treatment and how well it works. If a clinical trial reveals that a new treatment is better than the current standard of care, the new treatment may become the standard. Patients should consider taking part in the trial if they want to know whether this new treatment is right for them. Clinical trials are experiments that doctors do to find new ways to help people. Some clinical trials are open to patients who have not started treatment yet.

There are many clinical trials that can be found online at the National Cancer Institute's website. If you want more information, you can call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

Preparing for your appointment

If you have got any signs or symptoms that worry you, begin by creating a briefing together with your family doctor. If your doctor determines that you simply may have chronic white cell leukemia, you will be mentioned as a doctor who specializes in diseases of the blood and bone marrow (hematologist).

As a result, appointments will be brief, and since there's often heaps of {knowledge} to discuss, it's a decent plan to be prepared. Here's some information to assist you prepare and know what to expect from your doctor.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet.

  • Write down key personal information, including any major stresses or recent life changes.

  • Make a list of all medications, vitamins or supplements that you're taking.

  • Take a family member or friend along. Sometimes it is often tough to recollect all the data provided throughout an Associate in Nursing appointment. somebody who accompanies you'll recall one thing that you simply incomprehensible or forgot.

  • Write down questions to ask your doctor.

Your time along with your doctor is limited, therefore making an inventory of queries will assist you build the foremost of it slowly together. List your questions from most significant to least important just in case time runs out. For chronic WBC leukemia, some basic questions include:

  • What do my test results mean?

  • Do I need treatment right away?

  • If I don't begin treatment right now, will that limit my treatment options in the future?

  • Should I undergo additional tests?

  • What are my treatment options?

  • What are the side effects associated with each treatment?

  • Is there one treatment that's strongly recommended for someone with my diagnosis?

  • How will treatment affect my daily life?

  • I have other health conditions. How can I best manage them together?

  • Are there any brochures or other printed material that I can take with me? What websites do you recommend?

In addition to the queries that you've ready to raise your doctor, don't hesitate to ask questions as they occur to you throughout your appointment.

What to expect from your doctor

Your doctor is probably going to raise you a variety of questions. Being able to answer them might permit time to hide alternative points you would like to address. Your doctor may ask:

  • When did you first begin experiencing symptoms?

  • Have your symptoms been continuous or occasional?

  • How severe are your symptoms?

  • What, if anything, seems to improve your symptoms?

  • What, if anything, appears to worsen your symptoms?

General summary

Rituximab (Rituxan) is a monoclonal antibody against CD20 an antigen found on the surface of B cells It is an important medication in Chronic Lymphocytic Leukemia being used to treat both early and advanced CLL Rituximab has been shown to induce complete remission in those with CLL that are sensitive to the drug Beyond this it is also used as maintenance after the initial induction process has been undertaken.

Can chronic lymphocytic leukemia be cured?

Yes chronic lymphocytic leukemia (CLL) is highly treatable Even though CLL progresses slowly it can become life-threatening if not treated early The success of treatment depends on how advanced the disease is when diagnosed and the type of treatment used.

How long can a person live with chronic lymphocytic leukemia?

Chronic lymphocytic leukemia (CLL) is a form of cancer that affects the bone marrow causing abnormal white blood cells to accumulate in the body The disease most commonly affects people who are over age 65 and can be especially dangerous if not detected early enough CLL which is slow-growing can cause weakness and fatigue although it typically does not become life threatening until the patient begins experiencing complications such as infections or bleeding With treatment for this type of leukemia a person may live for 10 or 20 years beyond their initial diagnosis with no further symptoms.

What are the symptoms of end stage CLL?

Stage 4 is the final stage of chronic lymphocytic leukemia and it is also called end-stage CLL Symptoms are similar to those described for Stage 3 and include fatigue fever prolonged aches or pains weight loss and enlargement of the spleen or liver Patients may also be more susceptible to infections at this point because their immune system becomes compromised.

What should be avoided in CLL?

CLL is a B cell lymphoma that begins in the bone marrow and progresses to involve other organs People with CLL have an abnormal clone of lymphocytes which are white blood cells that play a key role in the immune response Over time the malignant CLL cells infiltrate multiple organs including the spleen and liver causing organ dysfunction and enlargement.

How do you know if CLL is getting worse?

The relationship between CLL and leukemia is not always clear. Some patients have no symptoms and never experience a relapse or remission while others develop leukemic cells due to the progression of their disease. If you notice any immediate changes in your health after chemotherapy, call your doctor immediately.

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Chronic lymphocytic leukemia (CLL): Causes, Types, Symptoms, Diagnosis and Treatment

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