Learn about this cancer that forms in white blood cells called lymphocytes. Treatments include chemotherapy, targeted therapy and immunotherapy.
Chronic lymphocytic leukemia (CLL) is a type of cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.
The term "chronic" in chronic lymphocytic leukemia comes from the fact that this leukemia typically progresses more slowly than other types of leukemia. The term "lymphocytic" in chronic lymphocytic leukemia comes from the cells affected by the disease — a group of white blood cells called lymphocytes, which help your body fight infection.
Chronic lymphocytic leukemia most commonly affects older adults. There are treatments to help control the disease.
Many people with chronic lymphocytic leukemia have no symptoms at first. Signs and symptoms might develop as the cancer progresses. They might include:
Make an appointment with your doctor if you have any persistent signs and symptoms that worry you.
Doctors aren't certain what starts the process that causes chronic lymphocytic leukemia. What's known is that something happens to cause changes (mutations) in the DNA of blood-producing cells. A cell's DNA contains the instructions that tell the cell what to do. The changes tell the blood cells to produce abnormal, ineffective lymphocytes.
Beyond being ineffective, these abnormal lymphocytes continue to live and multiply when healthy lymphocytes would die. The abnormal lymphocytes accumulate in the blood and certain organs, where they cause complications. They may crowd healthy cells out of the bone marrow and interfere with blood cell production.
Doctors and researchers are working to understand the exact mechanism that causes chronic lymphocytic leukemia.
Factors that may increase the risk of chronic lymphocytic leukemia include:
Chronic lymphocytic leukemia may cause complications such as:
Tests and procedures used to diagnose chronic lymphocytic leukemia include blood tests designed to:
Determine the type of lymphocytes involved. A test called flow cytometry or immunophenotyping helps determine whether an increased number of lymphocytes is due to chronic lymphocytic leukemia, a different blood disorder or your body's reaction to another process, such as infection.
If chronic lymphocytic leukemia is present, flow cytometry may also help analyze the leukemia cells for characteristics that help predict how aggressive the cells are.
In some cases, your doctor may order additional tests and procedures to aid in diagnosis, such as:
Once a diagnosis is confirmed, your doctor uses the information about your cancer to determine the stage of your chronic lymphocytic leukemia. The stage tells your doctor how aggressive your cancer is and how likely it is to get worse quickly.
Chronic lymphocytic leukemia stages can use letters or numbers. In general, the earliest stages of disease don't need to be treated right away. People with cancer in the later stages may consider beginning treatment immediately.
Your treatment options for chronic lymphocytic leukemia depend on several factors, such as the stage of your cancer, whether you're experiencing signs and symptoms, your overall health, and your preferences.
If your chronic lymphocytic leukemia doesn't cause symptoms and doesn't show signs of getting worse, you may not need treatment right away. Studies have shown that early treatment doesn't extend lives for people with early-stage chronic lymphocytic leukemia.
Rather than put you through the potential side effects and complications of treatment before you need it, doctors carefully monitor your condition and reserve treatment for when your leukemia progresses.
Your doctor will plan a checkup schedule for you. You may meet with your doctor and have your blood tested every few months to monitor your condition.
If your doctor determines that your chronic lymphocytic leukemia requires treatment, your options may include:
Bone marrow transplant. A bone marrow transplant, also known as a stem cell transplant, uses strong chemotherapy drugs to kill the stem cells in your bone marrow that are creating diseased lymphocytes. Then healthy adult blood stem cells from a donor are infused into your blood, where they travel to your bone marrow and begin making healthy blood cells.
As new and more-effective drug combinations have been developed, bone marrow transplant has become less common in treating chronic lymphocytic leukemia. Still, in certain situations this may be a treatment option.
Treatments may be used alone or in combination with each other.
Your doctor will meet with you regularly to monitor any complications you may experience. Supportive care measures may help prevent or relieve any signs or symptoms.
Supportive care may include:
No alternative treatments have been proved to cure chronic lymphocytic leukemia.
Some alternative medicine therapies may help you cope with fatigue, which is commonly experienced by people with chronic lymphocytic leukemia. Your doctor can treat fatigue by controlling the underlying causes, but often medications alone aren't enough. You may find relief through alternative therapies, such as:
Talk to your doctor about your options. Together you can devise a plan to help you cope with fatigue.
Chronic lymphocytic leukemia is typically a slow-growing cancer that may not require treatment. While some people may refer to this as a "good" type of cancer, it doesn't really make receiving a cancer diagnosis any easier.
While you may initially be shocked and anxious about your diagnosis, you'll eventually find your own way of coping with chronic lymphocytic leukemia. Until then, try to:
If you have any signs or symptoms that worry you, start by making an appointment with your family doctor. If your doctor determines that you may have chronic lymphocytic leukemia, you may be referred to a doctor who specializes in diseases of the blood and bone marrow (hematologist).
Because appointments can be brief, and because there's often a lot of information to discuss, it's a good idea to be prepared. Here's some information to help you get ready and know what to expect from your doctor.
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For chronic lymphocytic leukemia, some basic questions include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions as they occur to you during your appointment.
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow time to cover other points you want to address. Your doctor may ask: