Chronic Lymphocytic Leukemia

General Illness Information

Common Name: Leukemia, Chronic Lymphocytic

Medical Term: None Specified

Description: A slow growing cancer of blood forming cells, which produce a specific kind of white blood cell (lymphocyte). This causes proliferation of mature lymphocytes, with resulting infiltration of bone marrow.

More common in men over 60. Uncommon before 10 years of age. Rare in China and Japan.

Causes: Unknown. There may be a familial component.

Prevention: None known

Signs & Symptoms

There are usually no symptoms in the early stages. The illness is usually diagnosed at routine examination.

The following appear later in the disease course, and are gradual in onset:

  • Fatigue and general weakness.
  • Mild to moderate anemia.
  • Firm, enlarged lymph nodes.
  • Unexplained weight loss.
  • Susceptibility to infection.
  • Skin nodules (sometimes).

In later stages:

  • Inability to resist bacterial, viral or fungal infections;
  • Incapacitating weakness.

Risk Factors

Risk is much higher in men over 60 years of age.

Diagnosis & Treatment

Diagnostic tests may include laboratory studies of blood, bone marrow and cerebrospinal fluid, chest X-ray, CT scan and ultrasound.

General Measures:

  • Clinical staging is important for treatment and prognosis;
  • There are two forms of staging, based on clinical spread of the disease and the hematologic appearance;
  • Patients should avoid crowds to prevent dangerous exposure to infection, and should stay away from people with coughs and colds;
  • Mouth care is important. Rinse the mouth often with a warm salt-water solution to reduce the risk of mouth ulcers;
  • Supportive care includes transfusion of packed RBCs for anemia, platelet transfusions for bleeding associated with thrombocytopenia, and antimicrobials for bacterial, fungal, or viral infections.

Medications:

Specific therapy includes chemotherapy, corticosteroids, and radiotherapy. Treatment has not been proven to prolong survival. Overtreatment is more dangerous than undertreatment.
Many patients in the early stages do not require specific treatment, but close follow-up is necessary.

Activity:

No restrictions.

Diet:

No restrictions, no special diet.

Possible Complications:

  • Bleeding;
  • Reduced resistance to infections;
  • Gout;
  • Severe anemia;
  • Herpes zoster;
  • Bone marrow failure.

Prognosis

The median survival of patients with B-cell Chronic Lymphatic Leukemia or its complications is about 10 yr. Progression to bone marrow failure is usually associated with short survival. Patients with Chronic Lymphatic Leukemia are more likely to develop second malignancies.

Other

Nothing Specified.

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