Chronic lymphocytic leukemia
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Chronic lymphocytic leukemia or CLL is a form of blood and bone marrow cancer. This type of leukemia grows relatively slow when compared to other types of leukemia. Lymphocytes which are white blood cells that help the body fight against infection are affected in CLL.
Older adults are predominantly affected by chronic lymphocytic leukemia. The disease can be controlled by certain treatments.
Symptoms
In most cases, patients with chronic lymphocytic leukemia show no symptoms at an initial stage. Symptoms tend to develop as the cancer grows over time.
- Swollen lymph node
- Fatigue
- Fever
- Abdominal pain in the upper left side, which may be triggered enlarged spleen
- Sweats at night
- Unexplained weight loss
- Infections occur frequently
Consult a doctor if these signs and symptoms are persistent.
Causes
The causes of chronic lymphocytic leukemia have not been discovered. Some error occurs that causes mutations in the DNA of the cells that produce blood. The mutation of cell causes uncontrolled duplication resulting in abnormal lymphocytes which are ineffective at fighting infection. The abnormal lymphocytes begins to multiply themselves when lymphocytes that are healthy would die.
Complications arise when the accumulation of the abnormal lymphocytes occur in the blood and some other organs. The surrounding of the abnormal lymphocytes around the healthy cells separates them from the bone marrow and hamper the production of the blood cells.
Risk factors
- Age: Contributing risk factor, as chronic lymphocytic leukemia commonly develops in older adults.
- Race: People of white descendent are more prone to have the disease than people of other races.
- Record of blood and bone marrow cancers in the family: Patients having chronic lymphocytic leukemia or other types of blood and bone marrow cancers in the family are at risk of developing the disease.
- Chemicals Exposure: Some specific herbicides and insecticides have been associated with the risk of obtaining chronic lymphocytic leukemia.
- An illness that causes excess lymphocytes. Monoclonal B-cell lymphocytosis (MBL) increases the number of B-cell lymphocyte in the blood. A minimal number of people with this condition are at risk of developing chronic lymphocytic leukemia.
Diagnosis
Blood tests
- Complete blood count (CBC). A complete blood count with differential is helpful in counting the number of lymphocytes contains in a blood sample. If the sample consist of a high quantity of B cells, which is a type of lymphocyte, it may be an indications of chronic lymphocytic leukemia.
- Flow cytometry or immunophenotyping. This test helps reveal if the increased number of lymphocytes, is caused by chronic lymphocytic leukemia, other blood disease or the body’s reaction to infection. Flow cytometry also help analyze the characteristics of leukemia cells which help determine the aggressiveness of the cells.
- Analysis of lymphocytes for genetic changes. Fluorescence in situ hybridization (FISH) is a type of test that can inspect if there are any changes in the chromosomes located inside the lymphocytes that are cancerous.
Other tests
Leukemia cells could be tested to find characteristics that may have an impact on the prognosis
- Biopsy and aspiration of bone marrow
- Imaging tests include computerized tomography (CT) and positron emission tomography (PET) scan.
Staging
After the diagnosis have been made, the information will be used to determine the stage of chronic lymphocytic leukemia that patient has.
In most cases the very early stage of the disease does not require an immediate treatment. However, when the cancer progresses to more advanced stage, treatment may need to be started immediately.
Treatment
The treatment options for chronic lymphocytic leukemia vary upon numerous factors, including the stage, if there is an existence of any signs and symptoms and the overall health of the patient.
If patient does not have symptoms of chronic lymphocytic leukemia and does not have signs of progression, treatment may not be required right away. As studies revealed that early treatment does not have an effect in extending lives of people who have early stage of chronic lymphocytic leukemia.
Doctors will monitor your condition and start the treatment when the disease progresses. You will have to see the doctor and have the blood test every few months.
Treatments for intermediate and advanced stages
- Chemotherapy, a powerful drug that is designed to kill cancer cells that are rapidly growing. This treatment is given intravenously or through oral medication. Both single chemotherapy drug and a combination of several drugs could be used depending on the condition of the patient.
- Targeted drug therapy is a type of treatment that attacks particular abnormalities that are found in the cancer cells. Targeted therapy kills cancer cells by blocking these abnormalities to grow further.
- Immunotherapy is the involvement of a patient’s immune system to fight against cancer. The immune system in the body may not naturally fight against cancer because the cancer cells create proteins which make it easier for them to hide from the immune system cells. Immunotherapy interferes with this process.
- Bone marrow transplant (stem cell transplant) makes use of the strong chemotherapy drugs to destroy the stem cells in the bone marrow that are the causes of abnormal lymphocytes. Then healthy blood stem cells taken from an adult donor are injected into the blood. The healthy blood stem cells then travel to the bone marrow and start producing healthy blood cells.
