Living with Chronic Lymphocytic Leukemia (CLL): Understanding the Journey, Symptoms, and Treatment Options
By Marianna Herrera - Clinical Nurse Educator II - September 16, 2024
Chronic Lymphocytic Leukemia (CLL) is the most common form of leukemia in adults in Western countries. CLL is a disease of the white blood cells that typically affects adults over the age of 50 and is rarely seen in children. Most people do not have symptoms when diagnosed with CLL; however, some may present with enlarged lymph nodes. In late-stage diagnosis, patients may report fatigue, fever, night sweats, weight loss, pain in the upper left portion of the abdomen (due to an enlarged spleen) and frequent infections. Blood tests are performed to diagnose CLL. The most noteworthy laboratory abnormality found in CLL is an elevated lymphocyte count greater than 5,000 cells per microliter of blood. Flow cytometry is a key component to the diagnosis of CLL. Most cases can be identified using a panel of antibodies specific for CD5, CD19, CD20, CD23, and kappa and lambda immunoglobulin light chain.
B-cells originate in the bone marrow, develop in the lymph nodes, and normally fight infection by producing antibodies. In CLL, the B-cells do not work effectively and adversely affect the immune system. The disease causes an increase in B-cells in the bone marrow, which crowds out healthy cells.
Treating CLL may vary depending on the stage in which a person is diagnosed. Treatment highlights:
- Early stage CLL does not need to be treated and is termed a “watch and wait” period.
- CLL is a slow-growing disease, so patients can live normal lives without treatment for as long as a decade.
- Treatment is usually initiated when the patient’s clinical symptoms (severe fatigue, fever, night sweats, weight loss, enlarged lymph nodes,) or blood count progression that affects a patient’s quality of life.
- Drug therapies include antineoplastics and monoclonal antibodies.
- Bone marrow transplant for patients with refractory or recurrent disease. Bone marrow transplant is the only curative method for CLL.
- Immune globulin therapy is used to treat hypogammaglobulinemia and infections.
Many people live good quality lives with CLL with appropriate medical care. There is no known causes or prevention for CLL. Medical care should be determined depending on the progression the disease, by a hematologist and/or oncologist.
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