Chronic lymphocytic leukemia: Difference between revisions

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'''Other Names: '''
{{Infobox medical condition
Leukemia, lymphocytic, chronic; Chronic B-Cell Lymphocytic Leukemia; B Cell Chronic Lymphocytic Leukemia
| name          = Chronic Lymphocytic Leukemia
| image        =
| caption      =
| pronounce    =
| synonyms      = CLL
| specialty    = [[Hematology]], [[Oncology]]
| symptoms      = Often none, swollen [[lymph nodes]], fatigue, fever, infections, weight loss
| complications = [[Anemia]], infection, [[lymphoma]], [[autoimmune hemolytic anemia]]
| onset        = Gradual
| duration      = Long term
| types        =
| causes        = Unknown
| risks        = Family history, certain genetic mutations
| diagnosis    = Blood tests, bone marrow examination
| differential  = [[Acute lymphoblastic leukemia]], [[Monoclonal B-cell lymphocytosis]]
| prevention    =
| treatment    = Observation, [[chemotherapy]], [[radiation therapy]], targeted therapy, [[stem cell transplant]]
| medication    = [[Chlorambucil]], [[fludarabine]], [[rituximab]]
| prognosis    = Variable
| frequency    =
| deaths        =
}}


chronic lymphocytic leukemia (KRAH-nik LIM-foh-SIH-tik loo-KEE-mee-uh) is an indolent (slow-growing) [[cancer]] in which too many immature lymphocytes (white blood cells) are found mostly in the blood and [[bone marrow]]. Sometimes, in later stages of the disease, cancer cells are found in the [[lymph nodes]] and the disease is called small lymphocytic lymphoma. Also called [[CLL]].
'''Chronic lymphocytic leukemia''' (CLL) is a type of [[cancer]] that starts from cells that become certain [[white blood cells]] (called lymphocytes) in the [[bone marrow]]. CLL is characterized by the progressive accumulation of functionally incompetent lymphocytes. It is a type of [[leukemia]] which most often affects adults and typically progresses slowly. CLL is the most common type of leukemia in adults.
[[File:Diagram showing the cells CLL afects CRUK 296.svg|thumb|left|A diagram showing the cells affected by CLL]]
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== '''Signs and symptoms''' ==
== Signs and Symptoms ==
Early signs and symptoms may include swollen [[lymph nodes]], [[fatigue]], weight loss, fever, night sweats and/or frequent infections.
People with CLL may experience no symptoms initially. Over time, symptoms that may develop include:
 
* Enlargement of [[lymph nodes]]
The following list includes the most common signs and symptoms in people with chronic lymphocytic leukemia (CLL).  
* Fatigue
Signs and symptoms may include:
* Enlarged lymph nodes
* Enlarged liver and/or spleen
* Night sweats
* Fever
* Fever
* Fatigue
* Frequent infections
* Loss of appetite
* Weight loss
* Weight loss
* Frequent infections
* Night sweats
* Abnormal [[bruising]]
* Abdominal fullness due to enlarged spleen
Symptoms usually develop slowly, although CLL can progress quickly in rare cases.
[[Bone marrow]] changes may lead to low blood oxygen ([[anemia]]) and a low [[platelet]] count ([[thrombocytopenia]]).
The severity of CLL may depend on genetic and other factors, including the presence of underlying health conditions.
It is thought that CLL occurs following a pre-cancerous condition known as [[monoclonal B-cell lymphocytosis]] (MBL). MBL is present in about 10 percent of healthy adults. Only a small percentage of people with MBL develop CLL.
 
== '''Risk factors''' ==
CLL usually occurs in adults around the age of 70 and begins in the [[bone marrow]] and then spreads to the blood.
Other risk factors include age, exposure to [[pesticides]] or [[herbicides]], allergic conditions,
and a current [[hepatitis C]] infections.
 
== '''Cause''' ==
The underlying cause of chronic lymphocytic leukemia (CLL) is not known.
About 10% of people with CLL have a family history of this condition.
 
== '''Diagnosis''' ==
Chronic lymphocytic leukemia (CLL) is diagnosed through a clinical examination and specific blood tests. Sometimes CLL is first detected by chance during a routine blood test.
Tests that may be used to confirm a diagnosis of CLL include a [[blood count]], peripheral [[blood smear]], flow [[cytometry]], and a [[biopsy]] of the [[bone marrow]] or [[lymph nodes]].
 
== '''Treatment''' ==
Treatment for chronic lymphocytic leukemia (CLL) depends on many factors. These include the symptoms, the stage of the CLL, other diseases that are present, and whether the CLL has come back.
People with early stage CLL who have no symptoms may simply be closely monitored by their doctor without any treatment.
Treatment options may include, [[chemotherapy]], [[radiation therapy]], and [[targeted therapy]] (drugs used to find and kill cancer cells without hurting normal cells).
In younger patients, [[bone marrow]] or [[stem cell transplantation]] may be an option.
Specialists involved in the care of someone with CLL may include:
* Medical oncologist
* Radiation oncologist
* Hematologist
* Surgeon


The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition.
== Causes ==
* '''[[Ofatumumab]]''' (Brand name: Arzerra)Arzerra in combination with chlorambucil, for the treatment of previously untreated patients with chronic lymphocytic leukemia (CLL) for whom fludarabine-based therapy is considered inappropriate. Also Arzerra in combination with fludarabine and cyclophosphamide for the treatment of patients with relapsed chronic lymphocytic leukemia (CLL).
The exact cause of CLL is unknown. However, factors that may increase the risk include:
* '''[[Acalabrutinib]]''' (Brand name: CALQUENCE)CALQUENCE is indicated for the treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).
* Genetic mutations
Alemtuzumab (Brand name: Campath)The treatment of patients with B-cell chronic lymphocytic leukemia who have been treated with alkylating agents and who have failed fludarabine therapy.
* Family history of CLL
* '''[[PI3K-delta and PI3K-gamma inhibitor]]''' (Brand name: Duvelisib)PI3K-delta and PI3K-gamma inhibitor (Duvelisib) was approved for the treatment of adult patients with relapsed or refractory chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), or follicular lymphoma after at least two prior therapies.
* Exposure to certain chemicals
Buffered intrathecal electrolyte/dextrose injection (Brand name: Elliotts B Solution) -For the intrathecal administration of methotrexate and cytarabine for the prevention or treatment of meningeal leukemia and lymphocytic lymphoma.
* '''[[Fludarabine phosphate]]''' (Brand name: Fludara)
Fludarabine phosphate oral tablets (Brand name: Fludarabine (oral))Treatment of adult patients with B-cell chronic lymphocytic leukemia (CLL) whose disease has not responded to or has progressed during or after treatment with at least one standard alkylating-agent containing regimen.
* '''[[Obinutuzumab]] '''(Brand name: Gazyva) Treatment of patients with previously untreated chronic lymphocytic leukemia in combination with chlorambucil.
* '''[[Ibrutinib]]''' (Brand name: Imbruvica)Treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one prior therapy. Treatment of patients with chronic lymphocytic leukemia with or without 17p deletion.
* '''[[Rituximab and hyaluronidase human]]''' (Brand name: Rituxan Hycela)Treatment of adult patients with previously untreated and previously treated CLL in combination with fludarabine.
* '''[[Bendamustine hydrochloride]]''' (Brand name: Treanda)
* '''[[Venetoclax]]''' (Brand name: Venclexta)enetoclax (Venclexta) received expanded approval for the treatment of patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), with or without 17p deletion, who have received at least one prior therapy.
* '''[[idelalisib]]''' (Brand name: Zydelig)


== '''Statistics''' ==
== Diagnosis ==
It is estimated that about 4 in 100,000 people are diagnosed with chronic lymphocytic leukemia (CLL) every year in the US and Europe.
Diagnosis of CLL typically involves:
* Complete blood count (CBC) to check for increased lymphocytes
* [[Immunophenotyping]] to identify the types of cells involved
* [[Bone marrow]] examination
* [[CT scan]] or [[ultrasound]] may be used to check for swollen organs or lymph nodes


{{Hematological malignancy histology}}
== Treatment ==
{{Smallblueroundcelltumors}}
Treatment depends on the stage of the disease and symptoms. Options include:
* Observation or "watchful waiting" for early-stage or slow-progressing CLL
* [[Chemotherapy]]
* [[Radiation therapy]]
* Targeted therapy drugs like [[rituximab]]
* [[Stem cell transplant]] in certain cases


[[Category:Chronic lymphocytic leukemia| ]]
== Prognosis ==
[[Category:Small blue round cell tumor]]
The prognosis for CLL varies widely. Some patients live many years without treatment, while others may require immediate and aggressive therapy. Factors influencing prognosis include the stage of the disease, the patient's age, and overall health.
[[Category:RTT]]
{{rarediseases}}
{{stub}}


== Epidemiology ==
CLL primarily affects older adults and is rare in people under age 40. The incidence increases with age.


== See Also ==
* [[Leukemia]]
* [[Lymphoma]]
* [[Hematologic diseases]]


{{stub}}
[[Category:Hematologic diseases]]
[[Category:Cancers]]
{{medicine-stub}}
<gallery>
File:Chronic lymphocytic leukemia.jpg|Chronic lymphocytic leukemia
File:Smudge cell in a peripheral blood smear.jpg|Smudge cell in a peripheral blood smear
File:Diagram showing the cells CLL afects CRUK 296.svg|Diagram showing the cells CLL affects
File:Chronic lymphocytic leukemia - high mag.jpg|Chronic lymphocytic leukemia - high magnification
File:Smear cells.jpg|Smear cells
</gallery>

Latest revision as of 00:56, 20 February 2025

Chronic Lymphocytic Leukemia
Synonyms CLL
Pronounce
Specialty Hematology, Oncology
Symptoms Often none, swollen lymph nodes, fatigue, fever, infections, weight loss
Complications Anemia, infection, lymphoma, autoimmune hemolytic anemia
Onset Gradual
Duration Long term
Types
Causes Unknown
Risks Family history, certain genetic mutations
Diagnosis Blood tests, bone marrow examination
Differential diagnosis Acute lymphoblastic leukemia, Monoclonal B-cell lymphocytosis
Prevention
Treatment Observation, chemotherapy, radiation therapy, targeted therapy, stem cell transplant
Medication Chlorambucil, fludarabine, rituximab
Prognosis Variable
Frequency
Deaths


Chronic lymphocytic leukemia (CLL) is a type of cancer that starts from cells that become certain white blood cells (called lymphocytes) in the bone marrow. CLL is characterized by the progressive accumulation of functionally incompetent lymphocytes. It is a type of leukemia which most often affects adults and typically progresses slowly. CLL is the most common type of leukemia in adults.

Signs and Symptoms[edit]

People with CLL may experience no symptoms initially. Over time, symptoms that may develop include:

  • Enlargement of lymph nodes
  • Fatigue
  • Fever
  • Frequent infections
  • Weight loss
  • Night sweats
  • Abdominal fullness due to enlarged spleen

Causes[edit]

The exact cause of CLL is unknown. However, factors that may increase the risk include:

  • Genetic mutations
  • Family history of CLL
  • Exposure to certain chemicals

Diagnosis[edit]

Diagnosis of CLL typically involves:

Treatment[edit]

Treatment depends on the stage of the disease and symptoms. Options include:

Prognosis[edit]

The prognosis for CLL varies widely. Some patients live many years without treatment, while others may require immediate and aggressive therapy. Factors influencing prognosis include the stage of the disease, the patient's age, and overall health.

Epidemiology[edit]

CLL primarily affects older adults and is rare in people under age 40. The incidence increases with age.

See Also[edit]

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