Chronic Lymphocytic Leukemia

What is chronic lymphocytic leukemia?

Chronic lymphocytic leukemia (CLL) is a cancer in the bone marrow. When you have CLL, your body makes many abnormal lymphocytes (a type of white blood cell). When too many abnormal cells move into the bloodstream, they can keep other blood cells in the body from working properly.

How does it occur?

Blood cells are made in the bone marrow and are supposed to be fully grown when they enter the bloodstream. (Marrow is the soft, fatty tissue inside the hard, outer part of the bones.) Normal, fully mature lymphocytes help your body fight infection and other diseases. In CLL, many of these cells do not become fully mature and normal lymphocytes. These abnormal cells live longer than normal lymphocytes and accumulate in the blood. They are not able to fight infection very well. Also, as the number of abnormal cells in the blood and bone marrow increases, there is less room for healthy blood cells. This may result in infection, anemia, and easy bleeding.

The cause of the disease is not known. Most people who have CLL are over age 50, and it is more common in men than women. It is also more common in people who have close family members who have had it or related disorders.

What are the symptoms?

Chronic lymphocytic leukemia often has no or few symptoms. In some people, the first signs of the disease are:

• painless swelling of the lymph nodes in the neck, underarm, stomach, or groin
• feeling unusually tired
• an infection that does not go away, or frequent infections
• weight loss.

How is it diagnosed?

CLL is often found when a blood test is done for some other reason. The blood test will show an abnormally high white blood cell (lymphocyte) count. You may have other tests to help diagnose and classify the leukemia, such as a biopsy to look at samples of your bone marrow. For the biopsy, a needle is used to get the samples of marrow, usually from the back pelvic bone.

How is it treated?

In the early stage of CLL you will not need treatment. When your lymph nodes, spleen, or liver get a lot bigger or when the disease gets worse and you have symptoms, you need to be treated. Your healthcare provider will want to check you regularly. You may need to see a cancer specialist called an oncologist/hematologist.

When you need treatment, your cancer specialist will prescribe chemotherapy.

• Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing.
• Corticosteroid medicine may help control the growth of CLL cells.
• Monoclonal antibodies are artificial proteins. Your provider can put them into your bloodstream to attack other proteins on the leukemic cells and kill the cells. They also help the body's immune system to destroy other leukemic cells.

How long will the effects last?

The disease may slowly become worse over many years. How long you will live after diagnosis depends on the stage of the disease when it was diagnosed and how fast the cancerous cells are growing. Many people with CLL live normal lives for many years.

How can I take care of myself?

Make sure that you have regular checkups and follow your provider's advice for taking care of yourself. Also:

• Check with your healthcare provider before taking other medicines, including nonprescription products or other forms of treatment.
• Eat a healthy diet and get regular exercise.
• If you have a sore throat or fever or any kind of infection, call your provider for advice. You may need immediate treatment.
• Make sure you get a pneumonia shot and yearly flu shots.

If other family members have had CLL, your siblings, especially brothers, have a greater risk of getting the disease. People who have an increased risk of CLL should have regular checkups.

For more information, contact the Leukemia and Lymphoma Society at 800-955-4572 or visit their Web site at http://www.leukemia.org.

How can I help prevent chronic lymphocytic leukemia?

Because healthcare providers do not know what causes CLL and no risk factors have been found, no way is known to prevent it.