MedlinePlus Medical Encyclopedia: Chronic lymphocytic leukemia (CLL)

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Chronic lymphocytic leukemia (CLL)

Contents of this page:
Illustrations Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Support Groups Expectations (prognosis) Complications Calling your health care provider

Illustrations

Bone marrow aspiration

Auer rods

Chronic lymphocytic leukemia - microscopic view

Antibodies

Alternative names Return to top

CLL

Definition Return to top

Chronic lymphocytic leukemia is a malignancy (cancer) of the white blood cells (lymphocytes) characterized by a slow, progressive increase of these cells in the blood and the bone marrow.

Causes, incidence, and risk factors Return to top

Chronic lymphocytic leukemia (CLL) affects the B lymphocytes and causes immunosuppression, failure of the bone marrow, and invasion of malignant (cancerous) cells into organs.

Usually the symptoms develop gradually. The incidence is about 2 per 100,000 and increases with age (90% of cases are found in people over 50). Many cases are detected by routine blood tests in people with no symptoms. The cause of CLL is unknown. No relationship to radiation, carcinogenic chemicals or viruses has been determined. The disease is more common in Jewish people of Russian or East European descent, and is uncommon in Asia.

Symptoms Return to top

Enlarged lymph nodes, liver or spleen
Fatigue
Abnormal bruising (occurs late in the disease)
Excessive sweating, night sweats
Loss of appetite
Unintentional weight loss

Signs and tests Return to top

Elevated white blood cell count in a CBC
Flow cytometry revealing an abnormal population of white blood cells.
Bone marrow aspiration

This disease may also alter the results of serum protein electrophoresis.

Treatment Return to top

Since early treatment does not improve survival, early-stage disease often requires no specific treatment, but close observation is important. Chemotherapy may be needed if a patient develops fatigue, anemia, thrombocytopenia, or enlarged lymph nodes that are troublesome.

The anti-cancer medicine (chemotherapy) used first is usually fludarabine. Other medicines that may be used in this disease include chlorambucil (Leukeran) and cyclophosphamide (Cytoxan).

The treatment of CLL is changing rapidly. Recently, several new drugs, including alemtuzumab (Campath) -- which is an antibody against the surface of CLL cells -- has been approved for treatment of patients with CLL who have failed fludarabine. Another antibody drug, rituximab (Rituxan), may also be used alone or in combination with traditional chemotherapy. Rarely, radiation may be used for enlarged lymph nodes. Blood transfusions or platelet transfusions may be required.

Support Groups Return to top

The stress of illness may be eased by joining a support group whose members share common experiences and problems.

Expectations (prognosis) Return to top

The prognosis depends on the stage of the disease. Half of patients diagnosed in the earliest stages of the disease live more than 12 years. On the other hand, if CLL has reached an advanced stage, about half of these patients die within 2 years.

Complications Return to top

Increased risk of second malignancies
Side effects of chemotherapy
Bleeding from low platelets
Fatigue from anemia
Autoimmune hemolytic anemia
Idiopathic thrombocytopenic purpura (ITP)
Hypogammaglobulinemia (reduced levels of antibodies) with increased susceptibility to infection

Calling your health care provider Return to top

Call health care provider if you develop enlarged lymph nodes or unexplained fatigue, bruising, excessive sweating, or weight loss.

Update Date: 8/3/2004

Updated by: Marcia S. Brose, M.D., Ph.D., Assistant Professor, Hematology/Oncology, The University of Pennsylvania Cancer Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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