Expert Article: What Is Chronic Lymphocytic Leukemia? What Are The Symptoms? How To Manage?

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Chronic Lymphocytic Leukemia (CLL) is a type of blood cancer, primarily affecting a type of white blood called the lymphocytes.

CLL is characterized by excessive production of lymphocytes. The abnormal lymphocytes fail to function normally and also affect the functions of other blood cells and organs by crowding the bloodstream and tissues. It is a disease of the elderly with the usual age of onset in the 60s.

What are the symptoms of CLL?

CLL is a chronic condition that progresses slowly. During its early stages, the disease may not cause any symptoms.

In normal circumstances lymphocytes are responsible for immune functions, in CLL the abnormal lymphocytes weaken the immune system and lead to various health problems that clinically present with the following symptoms:

• Swollen or enlarged lymph nodes in the neck, armpits, and groin
• Constant unexplained fatigue
• Easy susceptibility to infections
• weight loss
• Excessive night-time sweating
• Fullness or generalized discomfort in the abdomen due to spleen enlargement
• Easy bleeding or easy bruising due to low platelets
• Dyspnea (shortness or difficulty in breathing)
• Anemia

Managing CLL

There is no definitive cure for CLL. However, there are several treatment approaches through which it can be managed with an improved quality of life.

The treatment is often decided based on various factors such as the reason for initiating therapy, the severity of the symptoms, and the individual's overall health. A few common treatment approaches include:

• Observation - Since CLL progresses slowly, in most cases it may not be necessary to start treatment immediately. Doctors recommend regular monitoring and initiate treatment when the disease advances.

• Targeted molecular therapies - Targeted molecular therapies are newer advances in cancer treatment and involve drugs that specifically target cancer cells without significantly affecting the healthy cells. Targeted molecular therapies have become the standard of care in CLL now. These are oral medications and work very well in the majority of patients.

• Immunotherapy - Immunotherapy is directed at destroying the abnormal lymphocytes directly as well as by altering the body's immune system to fight cancer cells.

• Chemotherapy - Chemotherapy helps kill the cancer cells or slow their growth. If required chemotherapy may be combined with other treatments. The use of chemotherapy has come down significantly with advances in targeted therapies.

• Bone marrow transplant - Bone marrow transplant is not needed in CLL except in very rare scenarios and in carefully selected patients where CLL is refractory to all other treatments.

The success and prognosis of the disease depend on various factors including, but not restricted to, the fitness of the patient, associated illnesses that the patient is carrying, the patient's age, and tolerance to the therapy being given.

Inputs by Dr. Ashish Dixit, Consultant - Haematology, Haemato Oncology & Bone Marrow Transplantation, Manipal Hospital.

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.