Chronic Lymphocytic Leukaemia: Symptoms, Causes, Treatment

Chronic Lymphocytic Leukaemia

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Various types of cancers can affect an individual. One such cancer is chronic lymphocytic leukaemia (CLL), which impacts the bone marrow and blood. Individuals with this condition have excessive production of abnormal lymphocytes, white blood cells responsible for fighting infections. It is a rare condition with an incidence of 0.41 per 100,000 in India. 

While CLL cannot be cured, various treatment options are available to put the condition into remission. This allows to manage the disease and improve the quality of life for patients. The following article discusses chronic lymphocytic leukaemia symptoms, causes, diagnosis, treatments, etc. Read on to learn more. 

Disease Name

Chronic Lymphocytic Leukaemia

Symptoms

Swollen lymph nodes, Shortness of breath, Fatigue, Fever, Night sweats

Causes

Genetics, Family history, Age, Gender, Chemical exposure

Diagnosis

Medical history, Peripheral blood smear, Flow Cytometry, Genetic tests, Bone marrow biopsy,  

Treated by

Medical Oncologist, Surgical Oncologist

Treatment Options

Chemotherapy, Targeted therapy, Immunotherapy, Stem cell transplantation

What is Chronic Lymphocytic Leukaemia?

Chronic Lymphocytic Leukaemia(CLL) is a cancer of the blood and bone marrow (the spongy, soft tissue inside a person’s bones where blood cells are produced). This type of leukaemia comprises two words, “chronic”, which means that it progresses slower than other types of cancer and “lymphocytic”, which signifies the cells affected by the disease, i.e., lymphocytes. 

It develops when healthy blood cells in the bone marrow change into cancerous cells. These cancerous cells multiply uncontrollably, crowding out healthy blood cells and platelets. CLL may not always present symptoms. Most people may get to know they have CLL after blood tests for routine physical examination. 

Types of Chronic Lymphocytic Leukaemia

Now that chronic lymphocytic leukaemia definition is clear, it is important to understand that it can develop in a person’s B-cells or T-cells, which are both types of white blood cells. 

  1. B lymphocytes or B-cells make antibodies to target bacteria, viruses, and other cancer cells. 

  2. T lymphocytes or T-cells control the body’s immune system response. They help the immune system fight and destroy abnormal cells, including cancer cells. 

B-cell chronic lymphocytic leukaemia develops in almost every individual with CLL. A condition that affects T-cells is called T-cell prolymphocytic leukaemia (PLL).  

Stages of Chronic Lymphocytic Leukaemia

CLL is typically classified into different stages based on the extent of the disease and the number of abnormal lymphocytes present. The two commonly used CLL staging systems are the Rai and Binet systems.

  1. Rai Staging System: According to this system, CLL is divided into five different stages, from 0 to IV. These stages are as follows:

    1. Stage 0: In this stage, there is an increased number of abnormal lymphocytes in the blood (lymphocytosis), but there is no enlargement of the lymph nodes, spleen, or liver.

    2. Stage I: Lymphocytosis and enlargement of lymph nodes are observed. However, there is no liver or spleen enlargement, and red blood cells and platelet are near normal. 

    3. Stage II: Lymphocytosis and enlargement of the spleen (and maybe liver) are present. Swollen lymph nodes may or may not be present. 

    4. Stage III: Lymphocytosis and anaemia (low blood cell count) are present. The patient may or may not have swelling in lymph nodes and an enlarged spleen or liver.

    5. Stage IV: Lymphocytosis and thrombocytopenia (low platelet counts) are present. The patient may or may not or may not have swollen lymph nodes, an enlarged liver or spleen, or anaemia. 

    6. Stage 0 is low risk, stages I and II are intermediate risk, and stages III and IV are high risk. 
  1. Binet Staging System: The Binet classification stages of CLL are based on whether the lymph nodes are found under the arms, neck, or groin area and whether patients have low levels of platelets and red blood cells.

    1. Stage A: In this stage, enlarged lymph nodes are present in less than three areas of lymphoid tissue. Red blood cells and platelet counts are within normal limits.

    2. Stage B: Enlarged lymph nodes are present in three or more areas of lymphoid tissue. Patients do not have anaemia or thrombocytopenia. 

    3. Stage C: There are several enlarged lymphoid tissue areas. Patients have anaemia and/or thrombocytopenia. 

Chronic Lymphocytic Leukaemia Symptoms

Chronic lymphocytic leukaemia symptoms can vary from person to person, and in some cases, individuals may not experience any symptoms, especially in the early stages of the disease. It may take months or even years for people to notice CLL symptoms. 

As the disease progresses, the following symptoms or clinical features of chronic lymphocytic leukaemia may occur:

  1. Swollen Lymph Nodes in the Underarm, Neck, Stomach, or Groin: This is usually the first common CLL symptom. Enlarged lymph nodes are generally not painful. 

  2. Fever: It is a sign of infection (CLL affects white blood cells, increasing the risk of infections)

  3. Fatigue: It can result from anaemia caused by CLL’s effect on red blood cells. 

  4. Fullness or Discomfort in the Upper Left Part of the Abdomen: This may be caused due to an enlarged spleen

  5. Shortness of Breath: Individuals may experience shortness of breath when enlarged lymph nodes or spleen press on the airway. 

  6. Frequent Infections: CLL impairs the immune system, making individuals more susceptible to infections.

  7. Night Sweats: Excessive sweating during the night is a symptom that some individuals with CLL may experience.

  8. Unexplained Weight Loss: CLL patients may experience unexplained weight loss, generally accompanied by loss of appetite. It is not a result of diet or exercise.

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Chronic Lymphocytic Leukaemia Causes

The exact chronic lymphocytic leukaemia causes are not known. However, it is known that these cancers develop from a change (mutation) in the DNA of the blood-forming cells. The DNA contains instructions that inform the cell what to do. Changes in the DNA inform the blood cells to produce abnormal lymphocytes.

The abnormal lymphocytes grow and multiply when healthy lymphocytes die. This accumulation of abnormal lymphocytes crowds healthy cells out of the bone marrow, interfering with blood cell production and causing complications. The cause for the change in the DNA is not understood. 

Chronic Lymphocytic Leukaemia Risk Factors

While it is not known what triggers changes in the cell’s DNA, there are certain identified risk factors. Factors that may increase the risk of developing chronic lymphocytic leukaemia include:

  1. Family History: Having a close relative, such as a parent or sibling with CLL, increases the risk of developing the disease by two to four times, but is not the sole reason. 

  2. Age: CLL is more commonly diagnosed in older adults. The average age at diagnosis is around 71 years. The risk of developing CLL increases with age.

  3. Gender: Men are at a slightly greater risk of developing CLL than women. However, the reasons for this gender difference are not fully understood.

  4. Exposure to Certain Chemicals: Prolonged exposure to certain chemicals, such as certain herbicides, insecticides, and pesticides, has been suggested as a possible risk factor for CLL. However, the evidence linking specific chemicals to CLL development is limited and further research is needed. 

  5. Monoclonal B-cell Lymphocytosis: This condition causes an increased number of identical B-cells in the patient’s blood. A small number of people with this condition may develop CLL. 

  6. Smoking and Alcohol Consumption: Several research evidence have found out smoking and alcohol consumption is one of the leading risk factors for major types of cancer. Smoking and alcohol consumption can also put an individual at a higher risk of CLL.

Prevention of Chronic Lymphocytic Leukaemia

There are very few known risk factors for CLL, most of which cannot be avoided. Most people who develop CLL have no risk factors. Therefore, currently, there are no known strategies for preventing the disease. However, one can reduce the risk of cancer by following these general preventive measures:

  1. Avoid Smoking: Tobacco use can lead to multiple cancers. Individuals should avoid using tobacco products to reduce their risk of cancer. 

  2. Limit Alcohol Consumption: Alcohol intake can increase the risk of breast, colon, oropharyngeal, and oesophageal cancer. Therefore, it is best to avoid or limit its consumption.  

  3. Avoid Radiation Exposure: People who work in an environment that requires radiation exposure should follow appropriate work safety measures.

  4.  Stay Physically Active: Inactivity can cause excess weight gain that leads to multiple types of cancer. Thus, individuals should lead a healthy and active life.

How is Chronic Lymphocytic Leukaemia Diagnosed?

The diagnosis of chronic lymphocytic leukaemia typically involves a combination of medical history assessment, physical examination, blood tests, and sometimes additional tests. Here are the main chronic lymphocytic leukaemia tests for diagnosis:

  1. Medical History and Physical Evaluation: The healthcare provider will inquire the patient about their symptoms, medical history, and family history of cancer or blood disorders. Next, they will perform a physical examination, including checking for enlarged lymph nodes, spleen, or liver.

  2. Complete Blood Count (CBC): A CBC is a blood test that measures the type and number of blood cells. In CLL, the CBC may reveal increased lymphocytes in the blood. Other blood cell counts, such as red blood cells and platelets, may also be evaluated.

  3. Peripheral Blood Smear: It is a microscopic examination of a blood sample. The test allows the doctor to visually examine the size, shape, and characteristics of cancerous blood cells. 

  4. Flow Cytometry: Flow cytometry is a laboratory technique that analyses the characteristics of cells in a blood sample. It can determine the proportion of different types of cells, including lymphocytes, and identify specific markers on the surface of these cells. In CLL, flow cytometry helps confirm if the lymphocytes in the blood sample contain CLL cells. 

  5. Genetic Tests: Tests such as fluorescent in situ hybridisation (FISH) and immunoglobulin heavy chain (IGHV) examine the patient’s chromosomes and genes. Understanding the mutation in chromosomes and genes can help determine prognosis and choose treatment. 

  6. Bone Marrow Biopsy and Aspiration: Usually, blood tests are enough to diagnose CLL. However, in some cases, a bone marrow biopsy may be performed to assess the involvement of CLL in the bone marrow. During this procedure, a small bone marrow sample (biopsy) and a small amount of bone marrow fluid (aspiration) are collected using a needle. The samples are then examined under a microscope. 

  7. Imaging Tests: X-rays, ultrasounds, CT scans, and MRIs are not done to diagnose CLL. However, they may be performed for other reasons, such as finding cancerous areas, determining cancer spread, or seeing if the treatment works. 

How to Prepare for Doctor’s Consultation?

Preparing for a doctor’s consultation is important to make the most of an individual’s time and ensure that their concerns and questions about chronic lymphocytic leukaemia are addressed effectively. Here are some steps to help prepare for a doctor’s consultation:

  1. Follow any pre-appointment restrictions: If the doctor has provided specific instructions or requested specific tests or reports before the consultation, the patient must comply with those requests.

  2. Note the symptoms: The patient must write down any symptoms they have been experiencing, even if they may be unrelated to CLL. Be specific and note when the symptoms started, their duration, and any factors that worsen or alleviate them.

  3. Prepare a list of questions: It is recommended to prepare a list of questions that the patient would like to ask their doctor, covering topics such as treatment options, potential side effects, prognosis, lifestyle modifications, and support resources.

  4. Make a list of medications: The patients must list all their medications, including prescription, over-the-counter, supplements, and herbs. They should include their dosages. This helps the doctor understand if there are any drug interactions. 

  5. Bring a trusted companion: Patients must consider bringing a family member or friend to the consultation for support and to help them remember the details discussed during the appointment. They can also help them ask questions or take notes.

What to Expect from the Doctor?

During a consultation appointment for chronic lymphocytic leukaemia, the doctor may ask the patient various questions to gather information about their condition and develop an appropriate treatment plan. Here are some questions the doctor may ask:

  1. What are the symptoms you are experiencing?

  2. When did you start experiencing these symptoms?

  3. How severe are your symptoms?

  4. Does anything seem to worsen or improve the symptoms?

  5. Have you had a recent injury or infection?

  6. Have you lost weight without trying?

  7. Do you have a family history of CLL or other blood disorders?

  8. What medications do you take?

  9. Have you received any previous treatments for CLL or other conditions?

What Questions to Ask the Doctor?

During a consultation for chronic lymphocytic leukaemia, individuals must ask their doctor relevant questions to understand their condition and make informed treatment decisions. Here are some questions they may consider asking:

  1. What type of CLL do I have?

  2. What is the stage of my leukaemia, and what does it mean for me?

  3. Do I need treatment right away?

  4. If not, how will I know when I need treatment?

  5. Should I get a second opinion?

  6. Will I need other tests before deciding on the treatment?

  7. What are my treatment choices? Which one do you recommend?

  8. What are the side effects of each treatment option?

  9. Will treatment put my cancer into remission?

  10. How long will the treatment last?

  11. How will CLL treatment affect my daily life?

  12. What is the outlook for my survival?

  13. What type of follow-up care will I need after CLL treatment?

  14. What are my treatment options if leukaemia returns?

  15. Are there any support services available for me and my family?

Chronic Lymphocytic Leukaemia Treatment

Chronic lymphocytic leukaemia treatment depends on several factors, including the stage of the disease, the presence of symptoms, the rate of disease progression, and individual patient characteristics. The following are common treatment approaches for CLL:

  1. Watchful Waiting: If CLL does not show any symptoms or does not get worse, the patient may not need treatment right away. The healthcare provider may recommend a “watch and wait” approach in early-stage CLL with no or minimal symptoms. 

    Rather than putting the patients through the potential complications of treatments before they need them, doctors regularly monitor blood counts, perform physical exams, and evaluate symptoms. This helps determine when treatment should be initiated.
  1. Chemotherapy: Administered through a vein or taken in a pill form, chemotherapy treatment is typically given in cycles to kill cancer cells. Chronic lymphocytic leukaemia medications for chemotherapy include fludarabine, cyclophosphamide, bendamustine, etc., which may be used alone or in combination.

  1. Targeted Therapy: Targeted therapy drugs, such as ibrutinib or venetoclax, specifically target certain molecules or pathways involved in CLL cell growth and survival. They can be highly effective and often have fewer side effects than traditional chemotherapy.

  1. Immunotherapy: The drugs used in this chronic lymphocytic leukaemia treatment strengthen the immune system to attack cancerous cells or slow down cancerous cell growth. Immunotherapy drugs like lenalidomide may be used to treat CLL that did not respond to chemotherapy, recurrent CLL, or CLL that gets worse. 

  1. Stem Cell Transplant: For individuals with high-risk CLL or relapsed/refractory disease, a stem cell transplant or a bone marrow transplant may be considered. This procedure involves replacing diseased bone marrow with healthy donor stem cells. 

    However, stem cell transplants have become less common with the development of newer, more effective drug combinations. 
  1. Clinical Trials: Clinical trials for CLL are research studies investigating new treatments to improve chronic lymphocytic leukaemia treatment protocols. Some individuals with CLL may participate in clinical trials to explore novel treatments, new drug combinations, or experimental therapies.

  1. Supportive Care: It aims to relieve signs and symptoms of the condition. The doctor may regularly monitor any complications the patient may experience. Supportive care measures include vaccinations to prevent infections, cancer screening, and monitoring other health problems. 

    Please Note: The selection of treatment approach is based on the patient’s health condition and the treating doctor’s opinion. 

Cost of Chronic Lymphocytic Leukaemia Treatment

The cost of chronic lymphocytic leukaemia treatment in India is generally influenced by several factors, including the stage of the cancer, treatment method used, patient’s age, patient’s comorbidities, hospital type and location, doctor’s expertise, insurance coverage and much more.

To know the exact cost of the CLL treatment, one must consult a reputed medical oncologist or the below table provides the approximate cost for various treatment modalities for CLL.

Surgery Name

Surgery Cost

Chemotherapy

₹ 75,000 to ₹ 2,50,000

Targeted Therapy

₹ 80,000 to ₹ 2,25,000

Immunotherapy

₹ 80,000 to ₹ 2,25,000

Stem Cell Transplant

₹ 15,00,000 to ₹ 27,00,000

Chronic Lymphocytic Leukaemia Survival Rates

Generally, chronic lymphocytic leukaemia treatment prognosis is good, and the condition has a high survival rate than other types of cancer. The five-year relative chronic lymphocytic leukaemia survival rate for people aged 20 and older is 87%. However, the individual prognosis may vary based on several factors, including:

  1. The stage of the disease

  2. Patient response to treatment

  3. Certain cellular and genetic markers

Risks and Complications of Chronic Lymphocytic Leukaemia

Chronic lymphocytic leukaemia affects a person’s white blood cells, red blood cells, and platelets. Without healthy blood cells and platelets, an individual may develop the following complications:

  1. Frequent Infections: CLL can weaken the immune system, making individuals more susceptible to infections. This includes bacterial, viral, and fungal infections, which can be potentially life-threatening.

  2. Lymphoma: Approximately 2% to 10% of individuals with CLL develop lymphoma (cancer of the lymphatic system). 

  3. Increased Risk of Other Cancers: Individuals with CLL may have a higher risk of developing other forms of cancer, like skin cancer, lung cancer, or colon cancer. This usually happens due to abnormalities in immune function caused by CLL. 

  4. Anaemia: CLL may result in an inadequate supply of red blood cells carrying oxygen throughout the body, which can lead to anaemia. 

  5. Thrombocytopenia: CLL can affect the platelet supply, causing thrombocytopenia.  

  6. Autoimmune Diseases: CLL can disrupt the normal functioning of the immune system, leading to the development of autoimmune disorders. Examples include autoimmune haemolytic anaemia (the immune system mistakenly attacks red blood cells) and autoimmune thrombocytopenia (the immune system mistakenly attacks platelets).

  7. An aggressive form of Cancer: In some cases, CLL can transform into an aggressive form of non-Hodgkin lymphoma, called diffuse large B-cell lymphoma or Richter syndrome.

Risks of Delaying Treatment

Indolent (slow-growing) CLL may remain stable without treatment for years. In its early stages, doctors may recommend watchful waiting without any risk of treatment delay. However, if the CLL is aggressive or fast-growing, it may require immediate treatment. Delaying treatment can lead to serious complications, such as:

  1. Anaemia

  2. Shortness of breath

  3. Fatigue

  4. Bleeding

  5. Difficulty fighting off infections

When to Call A Doctor?

An individual should see their doctor if they notice a change that is not normal or experiences any possible chronic lymphocytic leukaemia symptoms, including:

  1. Weight loss

  2. Fatigue

  3. Feeling full after just a few bites

  4. Swollen lymph nodes

  5. Night sweats

  6. A rapid heartbeat

  7. Unexplained bruising

Diet for Chronic Lymphocytic Leukaemia

Nutrition is important for everyone but becomes even more important for cancer patients. While no specific diet can cure CLL or replace medical treatment, maintaining a healthy diet may help boost energy and support recovery. Here are some general dietary recommendations that may be beneficial for individuals with CLL:

What to Include

  1. Water: Staying well-hydrated by drinking plenty of water throughout the day is crucial for maintaining optimal bodily functions and overall health. It also helps prevent treatment side effects like dry mouth and constipation. 

  2. Fruits and Vegetables: They include many antioxidants and phytochemicals, which may help individuals protect against cancer. People should eat vegetables like cauliflower, broccoli, cabbage, pumpkins, carrots, beets, etc., to receive the necessary minerals, vitamins, fibre, and other nutrients. 

  3. Healthy Fats: Cancer patients must consume healthy fats, such as extra virgin olive oil, olives, avocado oil, avocados, seeds, nuts, and fish like salmon and tuna. Some studies show that olive oil can reduce the risk of cancer. Moreover, the omega-3 fatty acids found in flax seeds have also been shown to protect individuals against cancer. 

What to Avoid

  1. Processed foods: Consumption of fast foods and processed meats can increase the risk of certain forms of cancer, such as colorectal, ovarian, and brain cancers.

  2. Alcohol: Heavy alcohol consumption can increase the risk of certain cancers. However, if someone chooses to drink alcohol, they must limit their alcohol intake to two drinks daily for men and one for women.

Takeaway

Chronic lymphocytic leukaemia is a complex disease characterised by the rapid growth of abnormal lymphocytes. It varies in progression and treatment options, requiring personalised approaches for each patient.

Ongoing research and advancements in treatment have improved outcomes and increased the possibility of long-term remission. Individuals with CLL must work closely with their healthcare team, staying informed and proactive in managing the disease.

HexaHealth offers valuable support for individuals with CLL. Our network of specialists provides access to haematologists, oncologists, and other experts who can provide expert guidance and personalised treatment plans.

We offer resources and information about CLL, including the latest updates in chronic lymphocytic leukaemia pathology outlines, enabling you to stay informed and actively participate in your healthcare decisions. With HexaHealth, you can confidently navigate your treatment journey, knowing you have a reliable support system in your corner. Contact us TODAY!

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FAQs for Chronic Lymphocytic Leukaemia

Chronic lymphocytic leukaemia (CLL) is a cancer type that begins in the bone marrow and affects white blood cells known as lymphocytes. It is characterised by the accumulation of abnormal lymphocytes, leading to impaired immune function and potential complications.

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Common chronic lymphocytic leukaemia symptoms include enlarged lymph nodes, fatigue, fever, loss of appetite, unexplained weight loss, night sweats, recurrent infections, easy bruising or bleeding, and discomfort or fullness in the upper abdomen due to an enlarged spleen.

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The exact chronic lymphocytic leukaemia causes are not fully understood, but it is known to be caused due to a change in the cell’s DNA that results in the abnormal growth of cancerous cells.

Certain genetic and environmental factors, like family history and exposure to certain chemicals or radiation, are believed to play a role in its development.

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There are primarily two types of chronic lymphocytic leukaemia - one that develops in the B-cells and the other in the T-cells. B-cell chronic lymphocytic leukaemia is the most common type of CLL.

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The disease diagnosis involves a combination of chronic lymphocytic leukaemia tests, including physical examinations, blood tests, bone marrow biopsy, and imaging studies. The presence of abnormal lymphocytes and specific biomarkers are used to confirm the diagnosis and determine the stage of the disease.

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Chronic lymphocytic leukaemia treatment depends on the stage and progression of the disease, as well as individual factors. The treatment option may include watchful waiting in the early stages, with no symptoms.

As the disease progresses, the doctor may recommend chemotherapy, targeted therapy, immunotherapy, stem cell transplant, or a combination of these approaches tailored to each patient’s needs.

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Chronic lymphocytic leukaemia is staged based on various factors, including the number of lymphocytes in the blood and bone marrow, the enlargement of lymph nodes or organs, and the levels of blood cells.

The stages range from 0 (early-stage) to IV (advanced-stage), indicating the extent of the disease and helping guide treatment decisions.

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Stage 4 CLL refers to an advanced stage of the disease where the patient has an abnormal number of lymphocytes in the blood and low platelet counts.

Furthermore, the patient may or may not have swollen lymph nodes, a liver or spleen that is enlarged, or amnesia. It indicates a high-risk stage and may require more intensive treatment approaches.

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Not all cases of chronic lymphocytic leukaemia require immediate treatment. In early stages or indolent (slow-growing) CLL, doctors often adopt a “watch and wait” approach with regular monitoring. Treatment is initiated when there is disease progression or development of symptoms that require intervention.

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Chronic lymphocytic leukaemia treatment options include chemotherapy, targeted therapy, immunotherapy, stem cell transplant, and in some cases, clinical trials. The treatment choice depends on factors such as the stage of the disease, patient characteristics, and individual treatment goals.

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The choice of the best first treatment for chronic lymphocytic leukaemia depends on several factors, including the patient’s overall health, disease stage, and genetic profile. The most common first-line treatments are targeted drugs like venetoclax and ibrutinib and chemotherapy drugs like fludarabine and cyclophosphamide.

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Chronic lymphocytic leukaemia definition is a cancer that begins in the person’s bone marrow and affects the lymphocytes. Lymphocytes are a type of white blood cell. The disease is characterised by the slow accumulation of abnormal lymphocytes in the bone marrow, blood, and lymph nodes.

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Yes, there are chronic lymphocytic leukaemia pathology outlines and features. Microscopically, CLL is characterised by the presence of ill-defined, small mature-appearing lymphocytes with round nuclei.

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Chronic lymphocytic leukemia (CLL) mainly affects lymphocytes, while chronic myeloid leukemia (CML) primarily affects myeloid cells.

CLL typically has a slow progression, while CML is characterized by the presence of the Philadelphia chromosome, a genetic abnormality. Treatment approaches and prognosis may also differ between the two types of leukemia.

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The histology of chronic lymphocytic leukaemia typically shows an accumulation of small mature-appearing lymphocytes.

The disease is characterised by the clonal expansion of CD5+, CD19+, and CD23+ B-cells accumulating in the bone marrow, blood, and lymphoid organs. Cytogenetic abnormalities, like deletion in chromosomes 17p, 11q or 13q, or trisomy 12, can also be observed.

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Yes, several medications and targeted therapies are used to treat chronic lymphocytic leukaemia. These chronic lymphocytic leukaemia medications include tyrosine kinase inhibitors (such as ibrutinib), BCL2 inhibitors (such as venetoclax), and monoclonal antibodies (such as rituximab and obinutuzumab), among others.

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Chronic lymphocytic leukaemia typically progresses slowly over time, with the accumulation of abnormal lymphocytes in the blood, bone marrow, and lymph nodes.

The rate of progression can vary among individuals, ranging from indolent, slow-progressing disease to more aggressive forms. Bone pain is a sign that cancer is growing more quickly.

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Chronic lymphocytic leukaemia has a complex genetic and molecular basis. It is characterised by specific genetic abnormalities, such as deletions in chromosomes 13q, 11q, or 17p, and trisomy 12, which have been associated with the prognosis of the disease.

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Even though the exact chronic lymphocytic leukaemia causes are unknown, certain environmental factors can increase the risk of the disease. These include prolonged exposure to certain chemicals, such as certain herbicides and insecticides.

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Chronic lymphocytic leukaemia treatment prognosis can vary depending on various factors, including the stage of the disease, genetic characteristics, response to treatment, and overall health. Most patients live for five years or more after being diagnosed.

Regular monitoring and advancements in treatment options have improved outcomes and survival rates for many patients.

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Yes, several markers and biomarkers are used to diagnose and monitor chronic lymphocytic leukaemia. These include CD5, CD19, dim CD20, dim CD22, CD23, bright CD43, etc., which are detected through immunophenotyping techniques like flow cytometry.

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Potential complications and long-term effects of treating chronic lymphocytic leukaemia can include increased risk of infections, bone marrow suppression, hair loss, fatigue, early menopause, reduction in fertility, secondary cancers, and adverse effects from specific therapies.

Regular monitoring and management of side effects are important for optimal patient care.

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If left untreated, chronic lymphocytic leukaemia can progress and lead to symptoms such as fatigue, anaemia, frequent infections, shortness of breath, bleeding, and an increased risk of complications such as autoimmune disorders or transformation to a more aggressive form of leukaemia.

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The recovery rate for chronic lymphocytic leukaemia varies depending on individual factors such as disease stage, genetic characteristics, and response to treatment. While doctors cannot cure the condition, advancements in treatment have improved outcomes and prolonged survival for many patients.

Around 88% of people with CLL live for five years or more after diagnosis.

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CLL is the most common leukaemia in adults in the United States, but it is relatively uncommon in India. The incidence rate of the disease in India is 0.41 per 100,000. There are limited studies on CLL from the Indian subcontinent.

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CLL usually develops very slowly, requiring little to no treatment. Although there is no cure for the disease, advancements in treatment options have helped many patients achieve long-term remission and manage the disease effectively, leading to a good quality of life.

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The overall chronic lymphocytic leukaemia survival rate varies depending on factors such as the stage of the disease, age, overall health, and response to treatment. With modern treatment approaches, the 5-year survival rate for CLL patients aged 20 years and older is around 87%.

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Yes, chronic lymphocytic leukaemia can come back after treatment. This is known as disease relapse or recurrence. Regular monitoring is important, and additional treatments may be required if CLL relapses.

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The 10-year survival rate for chronic lymphocytic leukaemia can vary depending on individual factors but is generally more than 70%. While the 10-year survival is significantly lower than the 5-year survival, it is possible to live ten years or more after diagnosis, highlighting improvements in treatment outcomes and long-term management of the disease.

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  1. Myth: CLL always requires immediate treatment.
    Fact: Not all cases of CLL require immediate treatment. In many cases, particularly in the early stages or in individuals with indolent CLL, a “watch and wait” approach is adopted, with regular monitoring to assess disease progression and determine the appropriate time to initiate treatment.

  1. Myth: Patients will experience noticeable symptoms.
    Fact: In the early stages, CLL usually does not cause any symptoms. Even if a person develops symptoms, they may be vague, making it difficult to determine their cause. Many symptoms that occur, like fatigue, fever, weight loss, frequent infections, etc., can also be caused by other conditions. 

  1. Myth: CLL treatment always involves chemotherapy.
    Fact: While chemotherapy has traditionally been a common treatment option for CLL, advancements in targeted therapies and immunotherapies have expanded the treatment landscape. In rare cases, doctors may also recommend stem cell transplants to help the body produce healthy lymphocytes. 

  1. Myth: Remission with treatment does not last long.
    Fact: Not true! The new and improved treatments for CLL have made it a survivable condition with longer periods of remission. After receiving the initial diagnosis, the ten-year survival rate is more than 70% for people with CLL.

  1. Myth: A change in diet can reverse CLL.
    Fact: While a diet high in processed foods may increase the risk of CLL, there is no evidence that a change in diet can reverse the disease or improve treatment. A nutritious diet only helps manage chronic lymphocytic leukaemia symptoms and treatment.

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References

All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.


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  2. Mayo Clinic Staff. Chronic Lymphocytic Leukemia - Symptoms and Causes [Internet]. Mayo Clinic. 2018. link
  3. Chronic Lymphocytic Leukemia (CLL): Symptoms, Outlook [Internet]. Cleveland Clinic. link
  4. Chronic Lymphocytic Leukemia Stages [Internet]. www.cancer.org. [cited 2023 Jun 29].link
  5. Chronic lymphocytic leukemia - Diagnosis and treatment - Mayo Clinic [Internet]. Mayoclinic.org. 2019.link
  6. Pennmedicine.org. 2023. link
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Disclaimer: The information provided here is for educational and learning purposes only. It doesn't cover every medical condition and might not be relevant to your personal situation. This information isn't medical advice, isn't meant for diagnosing any condition, and shouldn't replace talking to a certified medical or healthcare professional.

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Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES

12 Years Experience

Dr Aman Priya Khanna is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic, Health First Multispecialty Clinic in Delhi. He has 12 years of experience in General Surgery and worke...View More

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Sparshi Srivastava

Sparshi Srivastava

B.Tech Biotechnology (Bansal Institute of Engineering and Technology, Lucknow)

2 Years Experience

An ardent reader, graduated in B.Tech Biotechnology. She was previously associated with medical sciences secondary research and writing. With a keen interest and curiosity-driven approach, she has been able to cont...View More

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