Chronic Lymphocytic Leukemia

CHRONIC LYMPHOCYTIC LEUKEMIA lymph

Last Updated December 20th, 2021

Overview

Chronic lymphocytic leukemia is a form of blood cancer that affects a certain type of white blood cell known as the B-lymphocyte. There are several different types of blood cancers and these are generally told apart on the basis of examination of the cancer cells under the microscope. Most often, CLL is known to progress gradually but in some cases, it can be fast-growing cancer.

 

What Is Chronic Lymphocytic Leukemia Or CLL?

CHRONIC LYMPHOCYTIC LEUKEMIA WBCsChronic lymphocytic leukemia (CLL) is a type of low-grade non-Hodgkin’s lymphoma. The term ‘leukemia’ refers to blood cancer originating in the bone marrow and a ‘lymphocytic leukemia’ is one that originates in the cells that will eventually develop into lymphocytes (a type of white blood cell). There are four main types of leukemia, two of which are acute and two chronic forms. The degree of maturity of the cancer cells determines whether or not leukemia is acute or chronic. In chronic leukemia such as CLL, the cancer cells are partly mature and do retain some of the abilities of healthy and fully mature lymphocytes. Hence, it can take quite some time for symptoms to manifest.

Leukemia cells behave abnormally in the sense that they multiply uncontrollably. Unlike normal body cells, they do not die when they get worn out. As a result of this, they pile up in large quantities in the bone marrow and inhibit the production of other kinds of healthy blood cells. Leukemia can eventually spill over into the lymphatic system as well and affect organs such as the lymph nodes and spleen. Because healthy lymphocytes are involved in maintaining immunity by fighting infectious agents, the main hallmark of CLL is weakened immunity.

 

What Is The Cause For CLL?

Blood includes many different kinds of cells. All of these originate from a parent form known as the blood stem cell which is present in the bone marrow. Hence, the bone marrow serves as a factory or incubator for the formation of fresh blood cells.

HRONIC LYMPHOCYTIC LEUKEMIAA blood stem cell gives rise to two lineages of cells, namely, the myeloid and the lymphoid lineages. Myeloid cells develop into red blood cells, platelets and certain kinds of white blood cells known as granulocytes and monocytes. Lymphoid cells mature into B-lymphocytes, T-lymphocytes and natural killer cells. Chronic lymphocytic leukemia occurs when B-lymphocytes (B-cells) fail to mature properly, instead of producing abnormal cells called leukemia cells. Such malignant transformation is attributed to certain changes in the DNA of the affected cells. It is not known for certain what is responsible for these genetic mutations; however, certain risk factors have been identified. These include:

  • Having a close relative suffering from CLL, particularly first-degree relations doubles the risk of developing CLL.
  • Being male implies a slightly higher risk of developing CLL.
  • Being 60 years old or older.
  • Exposure to certain chemical substances increases the risk.
  • CLL appears to be more common in developed countries.
  • Belonging to certain racial or ethnic groups increases the likelihood of developing CLL.

 

What Are Its Symptoms?

In as many as one- third of patients, cancer remains stable and only mildly symptomatic for months or years. Such people may never require treatment. In other cases, the leukemia cells multiply faster and pile up rapidly in the marrow, outnumbering healthy lymphocytes. This gives rise to the following problems:

  • Weakened immunity and recurrent infections: Because the intrinsic function of lymphocytes is to maintain immunity by fighting infection, this is the main faculty that is weakened when a person has CLL.
  • Anaemia and thrombocytopenia: The accumulation of leukemia cells in the marrow disturbs the production of other kinds of blood cells. Hence, there are too few normal red blood cells, platelets and healthy white blood cells. This means that all the normal functions of the blood are effectively impaired. Several of the symptoms associated with leukemia are attributable to this. Lack of red blood cells is known as anaemia and lack of platelets is known as thrombocytopenia. The former condition leads to the reduced ability of the blood to supply oxygen to tissues and organs throughout the body. Platelets are responsible for forming clots in the event of bleeding. A deficit of platelets increases the possibility of blood loss even in the case of minor injuries.

Specific manifestations of the above conditions can be in the form of:

  • Painless swellings in lymph nodes in areas such as the armpit, groin, and neck.
  • Fever.
  • Chills.
  • Excessive sweating at night.
  • Recurrent infections.
  • Distention of the abdomen.
  • Pain in the area near the ribs.
  • Feeling short of breath.
  • Severe fatigue.
  • Reduced appetite.
  • Weight loss for no other identifiable reason.
  • Excessive bleeding from minor cuts or injuries.

 

What Are The Stages of Severity of CLL?

The severity of CLL is graded according to the following scheme, known as the ‘Rai staging system’:

  • 0: At this stage, the blood shows high numbers of lymphocytes but test results are otherwise normal and the disease is likely to remain stable.
  • I: Elevated numbers of lymphocytes is accompanied by swelling in the lymph nodes.
  • II: This stage is marked by enlargement of either the liver or spleen or both.
  • III: The patient’s haemoglobin levels have dropped significantly. At this point, there is a high probability of the disease worsening further.
  • IV: This stage is determined by the presentation of thrombocytopenia.

This system helps determine the form of treatment and also gives a sense of the prognosis. Those diagnosed with stages 0, I and II may not require treatment immediately but will be monitored for signs of progression of the disease.

 

What Are The Potential Complications?

CHRONIC LYMPHOCYTIC LEUKEMIA lymphThe following critical outcomes can be expected in association with CLL:

  • The patient suffers frequent infection, often with regard to the respiratory tract. This can even take the form of severe disease such as pneumonia, giving rise to further complications.
  • Autoimmune haemolytic anaemia is a possible complication. This condition is characterised by the immune system attacking healthy red blood cells thereby causing a severe form of anaemia.
  • About 1 in every 20 cases of CLL will progress into a more aggressive form of cancer called diffuse large B-cell lymphoma. This kind of transformation is referred to as Richter’s syndrome.
  • In some cases, CLL produces a condition known as light chain amyloidosis. Here, the leukemia cells produce light protein chains in quantities that exceed the body’s requirements and these excess proteins become deposited in tissues and organs, such as the kidneys. The patient may even suffer renal failure.
  • Complications can develop as a result of cancer treatment. Receiving chemotherapy and radiation therapy not only weakens the immunity, it can also increase the likelihood of infertility and of developing other forms of cancer.
  • Depression.
  • CLL can be a terminal illness.

 

What Tests Help To Diagnose CLL?

This list below describes procedures for diagnosing CLL:

  • Physical examination. The patient may display physical signs such as swollen lymph nodes and pallor of skin.
  • Complete Blood Count (CBC) Test: This helps determine the numbers of lymphocytes and also helps detect anemia or thrombocytopenia.
  • Immunophenotyping: This test helps determine the cause for elevated numbers of white blood cells. Once cancer is found to be responsible this test can also help assess how aggressive the leukemia cells are.
  • Fluoresence In Situ Hybridisation (FISH) Test: This test assesses chromosomal aberrations in the leukemia cells.
  • Bone marrow aspiration and biopsy: This involves examining samples of bone marrow under the microscope.
  • Diagnostic imaging: This helps to assess the condition of affected organs such as the liver or spleen.
  • Cancer Staging.

 

Treatment & Prevention

The most common method employed by doctors in case of CLL is “watchful waiting”. This includes carefully monitoring the symptoms, in cases of early-stage CLL, instead of using any measures for treatment.  If the CLL is in an advanced stage, the following treatment methods are used to destroy the cancer cells:

  • Chemotherapy
  • Biological therapy
  • Bone marrow transplant
  • Stem cell transplant

There are several side-effects of CLL treatment. It is important for the patient to receive treatment and management of these conditions as well:

  • Anemia
  • Excessive fatigue, weakness, and nausea
  • Increased vulnerability to infections ( due to low immunity)
  • Hair loss

There are no fixed preventive measures against CLL. Reducing/ eliminating hazardous chemical exposure such as through pesticides, herbicides, and radon can decrease one’s risk of developing CLL.

 

Facts

  • Almost 95% of all cases of Chronic Lymphocytic Leukemia ( CLL) begin in the B- cells or B- lymphocytes. These develop in the stem cells in the bone marrow.
  • Stem cells are the cells in the human body which have the capacity of turning into any type of cell such as skin, blood, liver, or even brain cells.

Facts

  • In the USA, every year 20,000 cases of CLL are reported. This is the most common form of leukemia in adults.
  • CLL is more common in males as compared to females. It is usually diagnosed among people in their middle age or older.

Facts

  • There are almost 4,500 deaths due to CLL in the USA every year. CLL comprises of 25% of all new cases of leukemia diagnosed yearly in the USA.

 

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Dos and Don'ts

Dos
  • Be sure to gather as much awareness as possible regarding the disease and discuss the treatment protocol thoroughly with your doctor.
  • Be careful with the side-effects of chemotherapy such as hair loss, nausea, fatigue etc. These tend to go away once the chemo sessions end.
  • Go for all the follow-up appointments and report all the side-effects of the cancer treatment you are facing to the concerned cancer team.
Don'ts
  • Assume that chemotherapy or any other form of therapy can cure you of the disease. This type of cancer can recur even after complete remission.
  • Expose yourself to immunity-weakening habits such as alcohol and tobacco consumption and unhealthy diet.
  • Lead a sedentary life. Indulging in regular physical fitness routines can cut down the risk of recurrence of the cancer.

 

 

 

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Piaget stages: Do they accurately describe the way the human brain develops?  A common assumption was that children are less competent thinkers as compared to adults, but this was refuted…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
colposcopy
Colposcopy Colposcopy is a simple, quick and non- invasive diagnostic tool to look closely inside the vulva, vagina, and…
CEA_test
Carcinoembryonic antigen (CEA) test CEA or carcinoembryonic test detects the presence of CEA antigen in your blood mainly & determines the effectiveness…
fructosamine test
Fructosamine Test A fructosamine test measures blood sugar glucose content. Fructosamine level can indicate blood sugar level in past 2-3…
nature health benefits
Green Healing: The amazing health benefits of being in nature You have no idea what sitting in a closed room does to your body and mind.Can a stroll…
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…
dandelion weight loss
Caralluma Fimbriata: How to eat this cactus to lose weight Caralluma fimbriata is a miracle cactus that can be safely consumed by most for losing weight and boosting…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
Atkins diet weight loss
Atkins Diet: The right steps to carb control that can help you lose those pounds fast The Atkins diet is a high fat, low-carb diet with proven weight loss benefits that is flexible enough…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
chloride test
Chloride Test A chloride test of the blood checks the level of chloride in body, an important factor governing the…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
valproic acid test
Valproic Acid Test Valproic acid test is performed to generally check for psychiatric and even neurological conditions such as bipolar disease…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
sodium blood test
Blood Sodium Test A blood sodium test measures the amount of sodium (an important electrolyte) in your body. It is also…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
Mood swings
The real reasons for your mood swings and how to overcome them Are you prone to heated moods frequently? Do you also feel bouts of depressive feeling creeping up on…
Quinine: How gin and tonic came to be known as a potent health elixir The discovery of quinine-containing tree bark is sometimes considered the most serendipitous medical discovery of the 17th century.
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
C-Reactive Protein Test A CRP or c-reactive protein blood test is an important diagnostic tool used to determine the risk of…
ANTIPHOSPHOLIPIDANTIBODY(APL)_IgG
Antiphospholipid (APL) antibody-IgG The Antiphospholipid Antibody testing is a blood test used to determine an autoimmune disorder called Antiphospholipid syndrome linked…
Strep throat pain
Anti-Streptolysin-O Test The ASO or Anti-Streptolysin-O is a blood test designed to check for the presence of streptococcus bacterial infection…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…