What is chronic lymphocytic leukemia?

Chronic lymphocytic leukemia, or CLL, is a type of cancer that affects the bone marrow and lymph system. It is most common among adults over age 60. Leukemia patients have an excessive number of white blood cells called lymphocytes-cells usually responsible for fighting infections. However, the abnormal lymphocytes of a leukemia patient cannot prevent infection as effectively as healthy white blood cells can. In addition, because they appear in large numbers in the blood, the abnormal white blood cells lower production of red blood cells, which are responsible for delivering oxygen to the body, and platelets, which are responsible for blood clotting. In chronic lymphocytic leukemia, the excess number of white blood cells is not usually due to overproduction but to the fact that the affected lymphocytes have an abnormally long life span.

What are the causes of chronic lymphocytic leukemia?

Chronic lymphocytic leukemia does appear to have a hereditary component, because family members of leukemia patients are three times more likely to develop the disease. Also, CLL is far more common in people over sixty, so age appears to be a factor in its development. In addition, many types of leukemia have been linked to benzene exposure. If you have transported benzene, gasoline, or worked in the petrolium or petro-chemical industries, click here to learn your legal rights.

What are the symptoms of chronic lymphocytic leukemia?

In its early stages, CLL may not present recognizable symptoms. As the disease progresses, the lymph nodes, spleen, or liver may swell. In addition, people with leukemia may experience persistent fatigue and small cuts or injuries may bleed excessively. During later stages of the disease, the number of red blood cells and platelets in the body drops. Other symptoms include: fever, headache, bruising easily, frequent infection, pain, and weight loss.

What are the treatments for chronic lymphocytic leukemia?

Unlike acute forms of leukemia, chronic lymphocytic leukemia is not usually curable. Patients may not need treatment until symptoms appear. The goals of treatment then are to bring about a period of remission and keep the disease in check. Treatment for CLL may include:

• Chemotherapy -- Chemotherapy uses one or more drugs to kill leukemia cells in the body. Chemotherapy for CLL may be administered orally, intravenously, through a catheter, or by injection directly into the cerebrospinal fluid.
• Biological Therapy/Immunotherapy - uses antibodies known as biological response modifiers (most often interferon) to boost the body's natural immune system. Interferon can inhibit cancer cell division, thereby slowing the growth of tumors. Monoclonal antibodies may also be used against chronic lymphocytic leukemia. Campath was approved for use in May of 2001 and Rituxan, a newer monoclonal antibody, is being tested for use with CLL.
• Radiation therapy - may be used to destroy leukemia cells or to shrink enlarged lymph nodes. Powerful rays of energy may be directed at specific areas of the body where many leukemia cells are or radiation may be used over the whole body. The latter is often used prior to bone marrow transplantation.
• Bone marrow transplantation/Stem cell transplantation - Bone marrow transplantation replaces the marrow damaged by treatment with healthy marrow. The donor marrow may come from the patient’s own body (autologous transplantation) if it is extracted and saved prior to treatment. It may also come from a donor (allogeneic transplantation).

Some patients may also need to have their spleen removed if it is enlarged. Patients may also need help with pain and side effects of treatment. Treatment for symptoms and side effects of CLL and other cancers is sometimes referred to as system management or palliative care.

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