Chronic Lymphocytic Leukemia (CLL)

Chronic lymphocytic leukemia (CLL) is a cancer that does occur once the bone marrow makes too many lymphocytes, a kind of white blood cellphone. CLL usually grows slowly compared to other leukemias, and maybe it doesn`t cause symptoms for some time.

CLL is just one of four main types of leukemia. It is the most common type of leukemia in adults; most people with CLL are middle-aged or older. The disease is quite rare in kids.

A person`s immature blood stem cells develop into lymphoid and myeloid stem cells. The myeloid cells act as mature blood cells: white blood cells, red blood cells, and platelets. Lymphoid stem cells grow into three types of lymphocytes:

• B-lymphocytes that make antibodies to help protect the body from germs

• T

• Natural killer cells, that also may kill viruses and cancer cells.

In CLL, too many blood stem cells develop in to lymphocytes. These cells don`t function correctly and they don`t undergo removal from the blood flow. Even in high numbers, they cannot fight infection in addition to normal cells. Since they pile up in the bloodstream and bone marrowthey crowd out healthy blood cells, red blood cells, and platelets. This could lead to disease, anemia, and effortless bleeding. CLL most frequently grows from B lymphocytes.

CLL begins in the bone marrow but since the abnormal lymphocytes multiply, they are discharged to the blood flow. In the time, it may spread to other parts of the human body that normally contain lymphocytes, such as the lymph nodes (in the throat, abdomen, and groin, underneath the arms( also round the collarbone), in addition to the liver and the spleen. These tissues might then become enlarged.

Certain factors can increase a person`s chance of developing CLL. These include

• Having cancer of the respiratory system or family members with CLL

• Being subjected to certain chemicals

• Becoming middle-aged or older

• Becoming white and male

• Being of European descent or North American.

Keep in mind, however, that having more than one risk factors for CLL doesn`t mean that you will develop the disease.

Infection

People with CLL often don`t have any symptoms or signs in the early stages of this disease. It could be detected during checkup or a routine blood test, or whenever there has been a blood test done for a different health problem.

Possible Indications of CLL comprise

• Fatigue and fatigue

• Lymph nodes in the neck

• Shortness of breath throughout activity that is normal

• Anxiety or sense of fullness below the ribs

• Stress

• unexplained weight loss

• Night sweats

• Bruising or bleeding easily

• Recurrent infections.

These symptoms can be associated with lots of non-cancerous ailments and other cancers. Tell your physician if you notice any one of them.

When there is a shortage of cells, Signs of CLL occur:

• People with a low red blood cell count might feel tired weak, or short of breath throughout activity.

• People with too few platelets bleed and bruise easily.

• Due to their immune systems are not working 21, people with a lack of white blood cells are prone to fevers and diseases. (Infections can vary in seriousness from frequent colds and cold sores into pneumonia.) However, many people with CLL could have elevated white blood cell counts because of the build-up of lymphocytes.

Diagnosis

Your physician will ask you if you might have symptoms such as fatigue, shortness of breath, or bruising. A physical exam will follow. Your physician will check lymph nodes and a enlarged spleen.

CLL may be diagnosed by a blood test. The first suggestion is an abnormally higher number of lymphocytes. A pathologist can confirm the diagnosis based on the existence of many abnormal-looking lymphocytes.

The cells in the bloodstream may look a lot like low grade lymphoma cells. That it might be tricky to tell apart CLL using this type of cancer of the lymph nodes. But both states grow and the treatment is most usually similar.

Your Physician may order evaluations and processes to diagnose CLL:

• Cytogenetic evaluation. This evaluation looks for specific improvements in the chromosomes of CLL cells. By way of example, part of a chromosome, that contains genetic information, may be missing. (In many CLL cases, there`s a big change in a minumum of one chromosome.) Knowing about chromosomal changes may help doctors determine whether or not a treatment is working or choose a treatment .

• Flow cytometry. This evaluation employs light sensitive dyes and lasers to look for many faculties in your cells. Specialists will check in your cells` outer lining for chemical mark. The evaluation may also help determine whether cancerous cells began from T lymphocytes or B lymphocytes.

• Lymph node biopsy. During this action, your physician will locate the site in your skin that lies over the lymph node. After numbing the skin he or she will earn a little incision. The lymph node is removed and sent to a lab.

• Bone marrow aspiration and biopsy. During this action, your doctor takes a small sample of bone and liquid bone marrow out of your hipbone or breastbone using a long needle. A pathologist (a specially trained doctor) examines the sample under a microscope for such factors as the number of CLL cells and also the patterns that they make in the bone marrow.

If you`re diagnosed with CLL, then you might be called a hematologist/oncologist.

As soon as you have been diagnosed, your doctor can do more tests to ascertain the degree of the CLL--that is, just how much the cancer has spread. This measure is called staging, plus it can help your doctor plan your treatment. As an example, your doctor might order a chest x ray, MRI scan, CT scan. These imaging evaluations create images of the own body`s insides. They can reveal abnormalities in organs or the back.

You can also have a lumbar puncture (spinal tap). During this action, a doctor uses a needle to withdraw a few fluid. This could possibly be done if she or he guesses that CLL cells have spread into the brain or back.

There are five stages of CLL, ranging from Stage 0. Period 0 means there are too many lymphocytes in the bloodstream, however that the affected person has no symptoms of leukemia. At the opposite end of the spectrum, Stage IV means that you`ll find numerous lymphocytes and too few platelets. The patient could have anemia (not iron( resulting from a lot of red blood cells) and enlarged lymph nodes, liver, or spleen. These stages could be classified as non -, intermediate-, and insecure.

Refractory CLL is.

Expected Duration

CLL usually grows and people may live for prolonged periods, sometimes for decades. Some instances require therapy and of CLL grow fast.

Prevention

There`s absolutely no known method.

Treatment

CLL generally can not be treated. The goals of treatment are to slow down the buildup of CLL cells, maintain an individual`s health, also allow the patient avoid infection. This is really actually a chronic disease and patients may live with minimal to no decrease in their wellbeing for extended intervals.

Decisions about fixing CLL be determined by several factors. These include

• Disease stage

• The person`s age and overall health

• Blood cell counts (white and red blood cells and platelets)

• Whether the person has symptoms

• Whether the liver, spleen, or lymph nodes are expanded

• The patient`s reaction to therapy

• Whether the CLL has come back (recurred).

Patients with low-risk (stage 0) CLL that isn`t climbing or growing slowly and that lack symptoms can wait to begin treatment--but continue with followup tests. This approachis known as watchful waiting, allows the person. But, problems such as disease, are treated.

Patients with intermediate- and insecure CLL (stages I--IV) that don`t have symptoms can delay treatment while continued to be observed. Treatment for Illness could comprise

• Chemotherapy with or without compounds or monoclonal antibodies (human-made immune system tissues )

• Several new medications are becoming available that have improved the outlook for patients both when other therapies have ceased working.

• Radiation therapy to areas where the cancer is available

• A stem cell transplant, a procedure that involves replacing a person`s abnormal blood-forming cells

• Surgery to remove the spleen

• Antibiotics to treat infections.

No side effects may be experienced by Many people receiving CLL treatment, while some face long-term and serious ones. Some side effects are

• anemia

• Extreme fatigue

• Illness

• Nausea

• Hair thinning.

The disease and its treatment may lead to additional complications. As an example, you can develop yet another cancer in the future, or you may develop a condition in.

Several new drugs have been already prescribed for CLL that can induce and sustain a remission for a long period of time.

When To Call a Pro

Call your physician if you have any symptoms of leukemia. It is critical to see that a physician that specializes in cancers if you`re diagnosed with CLL. These specialists are called hematologists and oncologists.

Also your doctor will tell you your white blood count is elevated and this could prompt a trip to a blood specialist.

Prognosis

A number of men and women live for years with good health, although There`s absolutely no cure for CLL. The outlook is dependent upon several factors. These include

• Whether there`s a big change in the DNA (genetic material) of the abnormal cells and, in that case, the sort of change

• Whether lymphocytes are spread across the bone marrow

• The disease period

• Whether the illness has arrived straight back or improves with treatment

• Whether the illness develops to an even stage that is more competitive

• The person`s overall health.

External resources

National Cancer Institute (NCI) NCI Public Inquiries Office6116 Executive BoulevardRoom 3036ABethesda, MD 20892-83221-800-4-CANCER (1-800-422-6237)TTY: 1-800-332-8615www. cancer.gov/

American Cancer Society (ACS)P.O. Box 56566Atlanta, GA 30343Toll-Free: 1-800-ACS-2345 (1-800-227-2345)TTY: 1-866-228-4327www. cancer.org/

Leukemia & Lymphoma Society1311 Mamaroneck Ave.White Plains, NY 10605Toll-Free: 1-800-955-4572www. leukemia.org

Further advice

Always consult with your healthcare provider to make sure the information displayed on this page pertains to your circumstances.