Chronic Lymphocytic Leukemia

What is leukemia?
Leukemia is cancer of the blood cells, usually the white blood cells.

What are the types of leukemia?
There are four main types of leukemia, which can be further divided into subtypes. When classifying the type of leukemia, the first steps are to determine if the cancer is:

1. lymphocytic or myelogenous leukemia:
Cancer can occur in either the lymphoid or myeloid white blood cells.

> When the cancer develops in the lymphocytes (lymphoid cells), it is called lymphocytic leukemia.

> When the cancer develops in the granulocytes or monocytes (myeloid cells), it is called myelogenous leukemia.

2. acute or chronic leukemia:
Leukemia is either acute or chronic.

> acute leukemia
The new or immature cells, called blasts, remain very immature and cannot perform their functions. The blasts increase in number rapidly, and the disease progresses quickly.

> chronic leukemia
Cells are more mature and grow more slowly, and the number increases less quickly, so the disease progresses gradually.

Based on these findings, the leukemia is then classified into one of the four main types of leukemias: acute myelogenous leukemia (AML); chronic myelogenous leukemia (CML); acute lymphocytic leukemia (ALL); or chronic lymphocytic leukemia (CLL).

What is chronic lymphocytic leukemia?

Chronic lymphocytic leukemia (CLL) is a cancer of the blood in which too many lymphocytes, a type of white blood cell, are produced by the bone marrow and by organs of the lymph system.

Normally, the lymphocytes fight infection by making antibodies that attack harmful elements. But, in CLL, the cells are immature and overabundant. They crowd out other blood cells, and may collect in the blood, bone marrow, and lymph tissue.

CLL usually occurs in people 60 years of age or older, and is almost twice as common as chronic myelogenous leukemia (CML). It is a slowly progressing disease.

What are the symptoms of chronic lymphocytic leukemia?

Early in the disease, there may be no noticeable symptoms. The following are the most common symptoms of chronic lymphocytic leukemia. However, each individual may experience symptoms differently. Symptoms may include:

  • persistent weakness
  • swollen lymph nodes
  • enlarged spleen
  • enlarged liver
  • anemia

The symptoms of chronic lymphocytic leukemia may resemble other blood disorders or medical problems. Always consult your physician for a diagnosis.

How is chronic lymphocytic leukemia diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for chronic lymphocytic leukemia may include the following:

  • additional blood tests and other evaluation procedures

  • bone marrow aspiration and biopsy - Bone marrow aspiration and/or biopsy - a procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.

  • other blood tests
Treatment for chronic lymphocytic leukemia:

Specific treatment for chronic lymphocytic leukemia will be determined by your physician based on:

  • your age, overall health, and medical history
  • presence of symptoms
  • presence of dangerously low normal blood cells
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

CLL is not a curable disease. However, the disease is highly treatable and often successful in completely alleviating symptoms for many years. Some patients need no treatment for 5-10 years. Treatment is usually given without hospitalization either by mouth or by vein.

Treatment consists of:

  • chemotherapy
  • supportive care measures such as transfusions, antibiotics and blood cell hormones to treat low blood counts.
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