Chronic Lymphocytic Leukemia
What is Chronic Lymphocytic Leukemia?
Chronic lymphocytic leukemia is a type of blood cancer that starts in white blood cells called lymphocytes. These cells are part of your immune system and help fight infections. In CLL, the bone marrow makes too many abnormal lymphocytes that don't work properly. These abnormal cells build up slowly over time in the blood and bone marrow.
CLL is the most common type of leukemia in adults in the United States. It typically affects people over age 60, though younger adults can develop it too. The word chronic means the disease usually grows slowly over months or years. This is different from acute leukemia, which grows quickly and requires immediate treatment.
Many people with CLL live for years without needing treatment. Some may never need treatment at all. Others will need therapy when the disease progresses or causes symptoms. Regular blood tests help doctors monitor the disease and decide when treatment is needed.
Symptoms
- Swollen lymph nodes in the neck, armpit, or groin that don't hurt
- Feeling very tired even after rest
- Frequent infections like colds, flu, or pneumonia
- Fever without an obvious cause
- Night sweats that soak through clothes or sheets
- Unintended weight loss of 10 pounds or more
- Pain or fullness below the ribs on the left side
- Easy bruising or tiny red spots on the skin
- Feeling full after eating only small amounts
Many people with early CLL have no symptoms at all. The disease is often found during routine blood work done for another reason. Some people live with CLL for years before noticing any changes in how they feel.
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Causes and risk factors
CLL happens when DNA changes occur in bone marrow cells that make lymphocytes. These changes cause the cells to multiply out of control and live longer than normal cells. Scientists don't know exactly what causes these DNA changes in most cases. CLL is not caused by anything you did or didn't do. It's not contagious and cannot be passed to others through contact.
Several factors increase the risk of developing CLL. Age is the biggest risk factor, with most cases occurring after age 60. Men are more likely to develop CLL than women. Having a family member with CLL or other blood cancers increases your risk. White people have higher rates of CLL than people of other races. Exposure to certain chemicals like Agent Orange may also raise risk. However, most people with these risk factors never develop CLL.
How it's diagnosed
CLL is usually found through blood tests that show higher than normal numbers of lymphocytes. Your doctor may order a complete blood count and other blood tests to check cell levels. Specific tests can measure biomarkers that indicate CLL and help predict how the disease may progress. Beta 2 Microglobulin levels often increase as CLL advances. Tests for immunoglobulins like IgG can show if your immune system is weakened. Smudge cells, which are fragile leukemia cells that break apart, often appear on blood smears in people with CLL.
Rite Aid offers blood testing that includes biomarkers used to monitor CLL and immune function. Our panels measure Beta 2 Microglobulin, IgG, light chain ratios, and CD4 to CD8 ratios through Quest Diagnostics. If your doctor suspects CLL, they may also recommend a bone marrow test or lymph node biopsy to confirm the diagnosis. Genetic tests on the cancer cells help determine the best treatment approach.
Treatment options
- Active monitoring with regular blood tests and physical exams if the disease is stable
- Chemotherapy drugs that kill cancer cells when treatment is needed
- Targeted therapy medications that attack specific proteins on cancer cells
- Immunotherapy drugs that help your immune system fight cancer cells
- Stem cell transplant for younger patients with aggressive disease
- Radiation therapy to shrink swollen lymph nodes or an enlarged spleen
- Antibiotics or antiviral drugs to prevent and treat infections
- Immunoglobulin replacement therapy if infection risk is high
- Eating a nutrient-rich diet to support immune function
- Getting adequate rest and managing stress
- Avoiding people who are sick to reduce infection risk
- Staying up to date with vaccines as recommended by your doctor
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Frequently asked questions
Chronic leukemia like CLL grows slowly over months or years and may not need immediate treatment. Acute leukemia grows quickly and requires treatment right away. People with chronic leukemia often live for many years, sometimes without symptoms. Acute leukemia causes severe symptoms that develop rapidly and can be life-threatening without prompt treatment.
Many people with CLL live normal lives for years, especially in early stages. Some never need treatment and can work, travel, and enjoy activities as usual. Others may need treatment but can still maintain good quality of life between therapies. Regular monitoring and following your doctor's advice help you stay as healthy as possible.
A high white blood cell count, especially lymphocytes above 10,000 per microliter, can indicate CLL. Your doctor may check Beta 2 Microglobulin levels, which rise as the disease advances. Tests for immunoglobulin levels like IgG show if your immune system is weakened. Smudge cells on a blood smear are a common sign of CLL.
CLL progresses at different rates for different people. Some people have stable disease for 10 years or more without treatment. Others may need treatment within a few years of diagnosis. Your doctor uses blood tests and genetic markers to predict how your CLL will likely behave.
CLL causes your body to make abnormal white blood cells that don't fight infections well. The disease also lowers levels of immunoglobulins, which are proteins that help your immune system work. As CLL progresses, you have fewer normal white blood cells to protect you. Some treatments for CLL also weaken the immune system temporarily.
Treatment is usually needed when symptoms start affecting daily life or the disease begins progressing quickly. Signs that treatment may be needed include frequent infections, severe fatigue, rapidly growing lymph nodes, or dropping blood counts. Your doctor will monitor your blood tests and symptoms to determine the right time. Many people are monitored for years before treatment becomes necessary.
While diet and lifestyle can't cure CLL, they support your overall health and immune function. Eating plenty of fruits, vegetables, and lean proteins gives your body nutrients it needs. Getting enough sleep and managing stress help your immune system work better. Avoiding sick people and practicing good hand hygiene reduce infection risk.
High Beta 2 Microglobulin in CLL usually means more advanced disease. This protein increases as more cancer cells build up in your body. Doctors use this marker along with other factors to predict prognosis and plan treatment. Higher levels may indicate you'll need treatment sooner rather than later.
CLL has some hereditary component but is not directly inherited like some genetic conditions. Having a close family member with CLL increases your risk by about two to seven times. However, most people with CLL have no family history of the disease. Genetic testing of cancer cells helps guide treatment but doesn't predict family risk.
Testing frequency depends on your disease stage and whether you're receiving treatment. People with stable early-stage CLL typically have blood tests every three to six months. Those with more active disease or on treatment may need monthly tests. Your doctor will create a monitoring schedule based on your specific situation.