Chronic lymphocytic leukemia (CLL), the most common type of leukemia in adults, is a type of cancer that occurs when abnormal mature white blood cells called lymphocytes accumulate in the blood and bone marrow.
The physicians at Colorado Blood Cancer Institute (CBCI) are specialists in the care of patients with CLL.
Chronic Lymphocytic Leukemia Causes
CLL is caused due to an acquired (not inherited) injury to the DNA of an abnormal single cell in the bone marrow. The result is the uncontrolled growth of lymphocytic cells in the bone marrow and an increase in the concentration of lymphocytes in the blood. Factors that may lead to a CLL diagnosis include:
- Family history
- Heavy exposure to herbicides and insecticides
- Heavy exposure to Agent Orange
Chronic Lymphocytic Leukemia Symptoms
Early stages of CLL may present few symptoms, with the disease being detected after an elevated white blood cell count is found in the blood. Symptoms of CLL, which usually develop gradually, include:
- Fatigue and shortness of breath
- Weight loss
- Frequent infections of the skin, lungs and kidneys.
- Pain or fullness in the belly (especially after eating a small meal)
Doctors distinguish between two types of CLL. One grows very slowly and rarely necessitates treatment, while the other often requires a more aggressive form of treatment.
Determining the stage of CLL is imperative to deciding which treatment method to pursue. CLL is separated into low, intermediate, and high-risk categories. Stage 0 is considered low risk; stages I and II are considered intermediate risk; and stages III and IV are considered high risk.
Chronic Lymphocytic Leukemia Treatment
Treatments for patients with CLL vary depending on the stage of the disease and symptoms experienced by the patient.
Patients without anemia (low platelet count) or markedly enlarged lymph nodes are not treated for CLL in favor of a “watchful waiting” approach that includes frequent monitoring by a hematologist.
The prognosis for low risk CLL is very good. Similar to “watchful waiting”, chemotherapy treatment is only considered if the leukemia begins to progress or if the patient is experiencing an increase in symptoms. Reasons for starting treatment include:
- Fever and sweats
- Enlarged lymph nodes and/or spleen
- Anemia, increased infections and low platelet count.
Intermediate and High-Risk CLL
Chemotherapy is the recommended treatment for patients with intermediate and high-risk CLL who exhibit symptoms. For patients with aggressive forms of the disease or when standard treatments have failed, stem cell transplantation is often used.
Occasionally, CLL can transform into a more aggressive form of leukemia or lymphoma, after which appropriate courses of treatment will be established.
Allogeneic Stem Cell Transplant
Allogeneic (donor) stem cell transplants were previously rarely used in the treatment of CLL. However, the use of newer techniques studied and developed by two of our physicians, Dr. Maris and Dr. McSweeney, has opened the doors to allogeneic transplantation as a viable treatment method for more aggressive forms of CLL.
Physicians at Colorado Blood Cancer Institute are pioneering new methods in chemotherapy and allogeneic stem cell transplantation to create every opportunity to effectively treat aggressive forms of CLL.
New drugs and treatments for CLL are being studied in the best laboratories around the world. Visit the National Comprehensive Cancer Network website to learn more about these and other treatment approaches.