Chronic Lymphocytic Leukemia

A generalized, progressive disease that's common in elderly people, chronic lymphocytic leukemia is marked by an uncontrollable spread of abnormal, small lymphocytes in lymphoid tissue, blood, and bone marrow. The prognosis is poor if anemia, thrombocytopenia, neutropenia, bulky lymphadenopathy, and severe lymphocytosis are present.

Nearly all patients with chronic lymphocytic leukemia are men over age 50. According to the American Cancer Society, chronic lymphocytic leukemia accounts for almost one-third of new leukemia cases annually.

Causes

Although the cause of chronic lymphocytic leukemia is unknown, researchers suspect hereditary factors (higher incidence has been recorded within families), still-undefined chromosome abnormalities, and certain immunologic defects (such as ataxia-telangiectasia or acquired agammaglobulinemia). The disease doesn't seem to be associated with radiation exposure.

Signs and symptoms

Early in the disease, there may be no noticeable symptoms. The following are the most common symptoms of chronic lymphocytic leukemia. However, each individual may experience symptoms differently. Symptoms may include:

• persistent weakness
• swollen lymph nodes
• enlarged spleen
• enlarged liver
• anemia

The symptoms of chronic lymphocytic leukemia may resemble other blood disorders or medical problems. Always consult your physician for a diagnosis.

Diagnosis

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

Treatment

Systemic chemotherapy includes alkylating agents, usually chlorambucil or cyclophosphamide, and sometimes steroids (prednisone) when autoimmune hemolytic anemia or thrombocytopenia occurs.

When chronic lymphocytic leukemia causes obstruction or organ impairment or enlargement, local radiation treatment can be used to reduce organ size. Allopurinol can be given to prevent hyperuricemia, a relatively uncommon finding.

Clinical trials. Some people with leukemia choose to enroll in clinical trials to try out experimental treatments or new combinations of known therapies. Several new drugs for CLL are being tested in clinical trials. Other clinical trials are exploring the effectiveness of bone marrow or stem cell transplant for treatment of CLL.

Supportive treatments. Having CLL increases your risk of developing infections and other complications. You may need vaccinations or medications to prevent or manage particular conditions that can be associated with CLL.