In this article, you can find a description and an explanation of how chronic lymphocytic leukaemia, a type of cancer that is in early phases asymptomatic, is identified and treated.
What is chronic lymphocytic leukaemia?
Chronic lymphocytic leukaemia (CLL) is a type of blood cancer (leukaemia) that starts in lymphocytes, the white blood cells, located in the bone marrow.
As a result of the leukaemia cells replacing the bone marrow’s normal blood-making cells, people with CLL don’t have enough red blood cells (anemia), properly functioning white blood cells (leukopenia), and blood platelets (thrombocytopenia).
The shortage of red blood cells causes tiredness, weakness, and shortness of breath. CLL also increases the risk of infections. People with CLL may have very high white blood cell counts because of excess numbers of lymphocytes (lymphocytosis), but the leukaemia cells don’t fight infection the way normal white blood cells do. This is mainly because their immune systems aren’t working as well as they should.
CLL is a cancer of B lymphocytes, which normally make antibodies that help fight infection. Because of the CLL, these antibody-making cells don’t work as they should, so they can’t fight infections. Infections may range from simple things like frequent colds or cold sores to pneumonia and other serious infections.
CLL can also affect the immune system in other ways. In some people with CLL, the immune system cells make abnormal antibodies that attack normal blood cells. This is known as autoimmunity.
How common is chronic lymphocytic leukaemia?
CLL accounts for about one-third of all leukaemias. The risk is slightly higher in men than in women, in particular, older adults up to 70 years. CLL is rarely seen in people under age 40 and is extremely rare in children.
What are the symptoms of chronic lymphocytic leukaemia?
Most of the time, CLL is asymptomatic or the symptoms are often vague and can be symptoms of other things.
Common symptoms can include the following:
- Weakness
- Feeling tired
- Weight loss
- Chills
- Fever
- Night sweats
- Swollen lymph nodes (often felt as lumps under the skin)
- Pain or a sense of „fullness“ in the belly (this can make someone feel full after only a small meal), which is caused by an enlarged spleen and/or liver
How is chronic lymphocytic leukaemia diagnosed?
Leukaemia is often found when your doctor orders blood tests for some unrelated health problem or during a routine check-up and you are found to have a high number of lymphocytes.
What are the risk factors for chronic lymphocytic leukaemia?
CLL is a complicated illness with a variety of consequences. One positive is that it starts and develops slowly over several years, before becoming chronic.
There are very few known risk factors for CLL. These include:
- Age: the risk of CLL goes up as you get older. About 9 out of 10 people with CLL are over age 50.
- Exposure to certain chemicals: Some studies have linked exposure to Agent Orange, an herbicide used during the Vietnam War, to an increased risk of CLL. Some other studies have suggested that farming and long-term exposure to certain pesticides may be linked to an increased risk of CLL. However, research is limited.
- Family history: First-degree relatives (parents, siblings, or children) of people with CLL have more than twice the risk.
- Gender: CLL is slightly more common in males than females. The reasons for this are not known.
- Race/ethnicity: CLL is more common in North America and Europe than in Asia. Asian people who live in the United States do not have a higher risk than those living in Asia. This is why experts think the differences in risk are related to genetics rather than environmental factors.
But risk factors don’t tell us everything. Having a risk factor, or even many risk factors doesn’t mean that you will get the disease. And some people who get the disease may not have had any known risk factors. Even if a person has a risk factor and develops cancer, it’s often very hard to know how much that risk factor may have contributed to the cancer.
What are the treatments for chronic lymphocytic leukaemia?
If you have a CLL diagnosis, it’s important to take time and think about your treatment options. Because CLL often grows slowly, not everyone needs to be treated right away. The likely benefits and side effects of each treatment have to be taken into consideration.
When treatment is needed, the main treatments are:
- Chemotherapy
- Monoclonal antibodies
- Targeted therapy drugs
- Supportive care
- Stem cell transplant
Each therapy has to be dosed on the patient‘s characteristics, which is why it is important to choose the right therapy and adapt it to your unique needs.
What is the plan if you have chronic lymphocytic leukaemia?
Remember that you are not alone in this journey. There are many specialists and centers already up to date with the possible therapies. In many cases, the first and best option is to monitor the illness in its slow development. As this phase can last several years, the watch-and-wait approach, also called “active surveillance” or “watchful waiting “, which includes regular medical examinations, is almost always adopted.
You may feel concerned to then learn that you will not begin treatment right away. But the watch-and-wait approach in comparison with several treatments is one of the most powerful treatments available today.
Many studies have compared the watch-and-wait approach to an early treatment approach for people with low-risk CLL:
- To date, no benefits of early treatment for people with low-risk CLL have been shown.
- Several studies have confirmed that the use of alkylating agents or aggressive chemotherapy in patients with an early-stage disease does not prolong survival.
- There are risks of early treatment, including potential side effects and treatment complications.
- Patients may build up a resistance to the drugs used and would not be able to use them again when treatment for the progressive disease is necessary.
You may be feeling overwhelmed or flooded with information coming from the internet or well-meaning friends and family who are concerned for you. It is best, after your doctor, to go to the chronic lymphocytic leukaemia treatment center closest to where you live. There you can find not only all the information you want but also the names of the most suitable specialists to follow your case.
As time is gentle with you and this kind of illness, it is a good idea to seek a second opinion. A second opinion can give you more information and help you feel more confident about the treatment plan you choose.
Disclaimer
The information contained herein is not and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Before making any changes to your diet, exercise or treatment, always consult your doctor or a qualified health professional.
The guidance provided may not be appropriate for your specific situation. Never make any decisions about your health based solely on the information provided in this article.
The author and creator of this article are not responsible for any damage or loss resulting from the improper use of the information presented here. Remember that each person is unique and therefore needs a personalized approach to health.
If you have any concerns about your health, please consult a qualified medical professional.