What is chronic lymphocytic leukemia?

Chronic lymphocytic leukemia (CLL) is a cancer of the blood in which too many lymphocytes, a type of white blood cell, are produced by the bone marrow and by organs of the lymph system.

Normally, the lymphocytes fight infection by making antibodies that attack harmful elements. But, in CLL, the cells are immature and overabundant. They crowd out other blood cells, and may collect in the blood, bone marrow, and lymph tissue.

According to the American Cancer Society, of the 33,440 leukemia cases expected in 2004 about 12,790 will be chronic. CLL will account for 8,190 of the chronic cases in 2004.

What are the symptoms of chronic lymphocytic leukemia?

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.

How is chronic lymphocytic leukemia diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for chronic lymphocytic leukemia may include the following:

• additional blood tests and other evaluation procedures
• bone marrow aspiration and biopsy - a procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.
• spinal tap/lumbar puncture - a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes the brain and spinal cord.

Treatment for chronic lymphocytic leukemia:

Specific treatment for chronic lymphocytic leukemia will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• stage of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment may include:

• chemotherapy
• radiation therapy
• treatment for complications, such as infection or anemia
• leukapheresis - a procedure to remove excess lymphocytes from the body.
• bone marrow transplantation
• splenectomy - surgery to remove the spleen