Chronic Lymphocytic Leukemia (CLL) occurs when lymphocytes increase in uncontrolled and abnormal numbers in the bone marrow, blood, and lymph nodes. Lymphocytes, which are one of the body's defense cells, cannot perform their duties, the body remains vulnerable to infections, leukemia cells that reach abnormal numbers prevent the production of normal cells, and disease symptoms occur. The median age is 72 years and only 10% of patients are under the age of 55. It is 2 times more common in men than in women.
Although the diagnosis is mostly made in the asymptomatic patient during routine tests, the patients mostly present to the physician with complaints of loss of appetite, weight loss, night sweats, weakness in daily activities, shortness of breath, susceptibility to infections, enlargement, and pain in the spleen, enlarged liver, enlarged lymph nodes, and anemia.
The first thing to be suspected in the diagnosis is the presence of lymphocytosis on the hemogram. In addition, anemia and thrombocytopenia may also occur. An increase in the number of lymphocytes in peripheral dissemination is in favor of leukemia. Staging is performed in patients diagnosed with CLL. RAI and BINET classification are used for staging.
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Treatment options for chronic lymphocytic leukemia (CLL) can vary greatly.
Many people live a long time with CLL, but in general it is very hard to cure, and early treatment hasn't been shown to help people live longer. Because of this and because treatment can cause side effects, doctors often advise waiting until the disease is progressing or bothersome symptoms appear before starting treatment.
If treatment is needed, factors that should be taken into account include the person’s age and overall health, and prognostic factors such as the presence of deletions in chromosomes.
References
Iwona Hus, Jacek Roliński. Current concepts in diagnosis and treatment of chronic lymphocytic leukemia. Contemp Oncol (Pozn). 2015; 19(5): 361–367. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709400/ [Accessed: July 2023]
https://lymphoma-action.org.uk/types-lymphoma/chronic-lymphocytic-leukaemia-cll-and-small-lymphocytic-lymphoma-sll [Accessed: July 2023]
B. Eichhorst , T. Robak et al. Chronic lymphocytic leukemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology Vol 32, Issue 1, P23-33, 2021 https://www.annalsofoncology.org/article/S0923-7534(20)42469-X/pdf [Accessed: July 2023]
https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/treating/treatment-by-risk-group.html [Accessed: July 2023]