Disease: Chronic lymphocytic leukemia

    Overview

    Chronic lymphocytic leukemia (CLL) is a type of cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.

    The term "chronic" in chronic lymphocytic leukemia comes from the fact that it typically progresses more slowly than other types of leukemia. The term "lymphocytic" in chronic lymphocytic leukemia comes from the cells affected by the disease — a group of white blood cells called lymphocytes, which help your body fight infection.

    Chronic lymphocytic leukemia most commonly affects older adults. There are treatments to help control the disease.

    Chronic lymphocytic leukemia care at Mayo Clinic

    Source: http://www.mayoclinic.com

    Symptoms

    Many people with chronic lymphocytic leukemia have no early symptoms. Those who do develop signs and symptoms may experience:

    • Enlarged, but painless, lymph nodes
    • Fatigue
    • Fever
    • Pain in the upper left portion of the abdomen, which may be caused by an enlarged spleen
    • Night sweats
    • Weight loss
    • Frequent infections

    When to see a doctor

    Make an appointment with your doctor if you have any persistent signs and symptoms that worry you.

    Source: http://www.mayoclinic.com

    Causes

    Doctors aren't certain what starts the process that causes chronic lymphocytic leukemia. What's known is that something happens to cause a genetic mutation in the DNA of blood-producing cells. This mutation causes the blood cells to produce abnormal, ineffective lymphocytes.

    Beyond being ineffective, these abnormal lymphocytes continue to live and multiply, when normal lymphocytes would die. The abnormal lymphocytes accumulate in the blood and certain organs, where they cause complications. They may crowd healthy cells out of the bone marrow and interfere with normal blood cell production.

    Doctors and researchers are working to understand the exact mechanism that causes chronic lymphocytic leukemia.

    Source: http://www.mayoclinic.com

    Diagnosis

    Blood tests

    Tests and procedures used to diagnose chronic lymphocytic leukemia include blood tests designed to:

    • Count the number of cells in a blood sample. A complete blood count may be used to count the number of lymphocytes in a blood sample. A high number of B cells, one type of lymphocyte, may indicate chronic lymphocytic leukemia.
    • Determine the type of lymphocytes involved. A test called flow cytometry or immunophenotyping helps determine whether an increased number of lymphocytes is due to chronic lymphocytic leukemia, a different blood disorder or your body's reaction to another process, such as infection.

      If chronic lymphocytic leukemia is present, flow cytometry may also help analyze the leukemia cells for characteristics that help predict how aggressive the cells are.

    • Analyze lymphocytes for genetic abnormalities. A test called fluorescence in situ hybridization (FISH) examines the chromosomes inside the abnormal lymphocytes to look for abnormalities. Doctors sometimes use this information to determine your prognosis and help choose a treatment.

    Other tests

    In some cases, your doctor may order additional tests and procedures to aid in diagnosis, such as:

    • Tests of your leukemia cells that look for characteristics that could affect your prognosis
    • Bone marrow biopsy and aspiration
    • Imaging tests, such as computerized tomography (CT) and positron emission tomography (PET)

    Staging

    Once a diagnosis is confirmed, your doctor determines the extent (stage) of your chronic lymphocytic leukemia. Your doctor will use information about your cancer to assign a stage — early, intermediate or advanced — that indicates the progression of your chronic lymphocytic leukemia.

    In general, people with early-stage disease don't require immediate treatment. Those with intermediate-stage disease and advanced-stage disease may be given the option to begin treatment right away.

    Source: http://www.mayoclinic.com

    Complications

    Chronic lymphocytic leukemia may cause complications such as:

    • Frequent infections. People with chronic lymphocytic leukemia may experience frequent infections. In most cases, these infections are common infections of the upper and lower respiratory tract. But sometimes more-serious infections can develop.
    • A switch to a more aggressive form of cancer. A small number of people with chronic lymphocytic leukemia may develop a more aggressive form of cancer called diffuse large B-cell lymphoma. Doctors sometimes refer to this as Richter's syndrome.
    • Increased risk of other cancers. People with chronic lymphocytic leukemia have an increased risk of other types of cancer, including skin cancer, such as melanoma, and cancers of the lung and the digestive tract.
    • Immune system problems. A small number of people with chronic lymphocytic leukemia may develop an immune system problem that causes the disease-fighting cells of the immune system to mistakenly attack the red blood cells or the platelets.

    Source: http://www.mayoclinic.com

    Alternative medicine

    No alternative treatments have been proved to cure chronic lymphocytic leukemia.

    Alternative treatments for coping with fatigue

    Some alternative medicine therapies may help you cope with fatigue, which is commonly experienced by people with chronic lymphocytic leukemia. Your doctor can treat fatigue by controlling the underlying causes, but often medications alone aren't enough. You may find relief through alternative therapies, such as:

    • Exercise
    • Massage
    • Meditation
    • Relaxation techniques
    • Yoga

    Talk to your doctor about your options. Together you can devise a plan to help you cope with fatigue.

    Green tea extracts for people with early-stage leukemia

    A green tea extract has shown some promise in initial clinical trials for treating chronic lymphocytic leukemia. Laboratory research determined that a compound in green tea extract, called EGCG, can kill chronic lymphocytic leukemia cells. A study of people with early-stage chronic lymphocytic leukemia found that EGCG in pill form reduced some signs of the disease. But green tea trials haven't been conclusive, and this subject requires more study before doctors can agree on the merits of this treatment.

    Source: http://www.mayoclinic.com

    Coping and support

    Chronic lymphocytic leukemia is typically a slow-growing cancer that may not require treatment. While some people may refer to this as a "good" type of cancer, it doesn't really make receiving a cancer diagnosis any easier.

    While you may initially be shocked and anxious about your diagnosis, you'll eventually find your own way of coping with chronic lymphocytic leukemia. Until then, try to:

    • Find out enough about your cancer to make decisions about your care. Write down questions to ask your doctor before each appointment and look for information in your local library and on the internet. Good sources include the National Cancer Institute, the American Cancer Society, and the Leukemia & Lymphoma Society.
    • Turn to family and friends for support. Stay connected to family and friends for support. It can be tough to talk about your diagnosis, and you'll likely get a range of reactions when you share the news. But talking about your diagnosis and passing along information about your cancer can help. So can the offers of help that often result.
    • Connect with other cancer survivors. Consider joining a support group, either in your community or on the internet. A support group of people with the same diagnosis can be a source of useful information, practical tips and encouragement.
    • Explore ways to cope with the nagging, chronic nature of the disease. If you have chronic lymphocytic leukemia, you'll likely face ongoing tests and ongoing worries about your white blood cell count. Try to find some activities that help you relax, whether it's yoga, exercise or gardening. Talk to a counselor, therapist or social worker if you need help dealing with the emotional challenge of this chronic disease.

    Source: http://www.mayoclinic.com

    Risk factors

    Factors that may increase the risk of chronic lymphocytic leukemia include:

    • Your age. This disease occurs most often in older adults. On average, people diagnosed with chronic lymphocytic leukemia are in their 70s.
    • Your race. Whites are more likely to develop chronic lymphocytic leukemia than are people of other races.
    • Family history of blood and bone marrow cancers. A family history of chronic lymphocytic leukemia or other blood and bone marrow cancers may increase your risk.
    • Exposure to chemicals. Certain herbicides and insecticides, including Agent Orange used during the Vietnam War, have been linked to an increased risk of chronic lymphocytic leukemia.

    Source: http://www.mayoclinic.com

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