Chronic Lymphocytic Leukemia (CLL)
Symptoms of Chronic Lymphocytic Leukemia
Because CLL tends to grow slowly, many people with the disease have no symptoms for a few years. If this is the case, your doctor may "stumble across" your CLL after you've had blood tests for some other reason.
Any CLL symptoms you do have may be vague and difficult to pinpoint. General symptoms of chronic lymphocytic leukemia include:
- extreme fatigue
- weight loss
- fever or night sweats
- lump under the skin, such as in the neck, groin, or arm pit (from enlarged lymph nodes)
- pain or increased "fullness" in the belly (from an enlarged spleen)
If CLL is more advanced, leukemia cells begin to replace normal blood-making cells. Then you may experience other symptoms. These symptoms result from the leukemia crowding out healthy cells. For example:
Shortage of red blood cells. This may cause symptoms of anemia, including:
- shortness of breath
Shortage of normal white blood cells. This may cause:
- infections (recurring or severe)
Shortage of blood platelets. This may cause:
- bleeding from gums
Stages of Chronic Lymphocytic Leukemia
Staging for most cancers looks at the size of a tumor and how far the cancer has spread. Leukemia is different, though. There is not a tumor, and the leukemia cells have often traveled to other organs when first detected. So CLL staging looks at other features to determine a likely outcome and the best treatment options.
In the U.S., the most common staging doctors use for CLL is the Rai staging system. They look at three risk groups when suggesting treatment options:
CLL Stage 0. This stage is low risk. The blood and bone marrow contain a high lymphocyte count. Lymphocytes are a type of white blood cell.
CLL Stages I and II. These are intermediate-risk stages. Patients have a high lymphocyte count. There is also swelling of the:
CLL Stages III and IV. These are high-risk stages. In addition to a high lymphocyte count, the red cell count or platelet counts are low -- with or without swelling.
Treatment for Chronic Lymphocytic Leukemia
Depending upon the type and stage of your CLL, you may not need treatment -- or at least not right away. When advising you about treatment options, your doctor will also take into account:
- your age
- overall health
- benefits and side effects of treatment
It is often a good idea to get a second opinion.
You may have one or more of these types of treatment for chronic lymphocytic leukemia:
Here are some details about these treatments.
Chemotherapy. This is a treatment with anti-cancer drugs. Many of these drugs must be given by vein (IV). But some may be taken by mouth. Some examples of CLL chemotherapy drugs are: