Leukemia is cancer of the white blood cells. Bone marrow is spongy tissue in the middle of bones. Blood cells form and develop in marrow and then move into the bloodstream. Leukemia can be acute or chronic. Acute leukemia affects cells in bone marrow before they fully develop. Chronic leukemia affects fully grown cells.
Chronic lymphocytic leukemia (CLL) causes too many white blood cells to be produced. These cells don’t work normally, so people have greater chances of getting serious infections and bleeding.
CLL is the most common type of leukemia in Western countries. It usually occurs among people older than 60, in women twice as often as men. Many people with CLL have a normal lifespan due to a long life expectancy with this disease and the elderly age of most people at time of diagnosis. CLL cannot be prevented.
The cause of CLL is unknown. It cannot be caught but does seem to run in families. Also, one third of people with CLL have an extra chromosome 13 (producing trisomy 13). Farmers exposed to certain pesticides and people who work with rubber or asbestos may have an increased risk.
The most common symptoms are feeling sick and extremely tired. Swollen glands (enlarged lymph nodes) or recurrent infections due to a weakened immune system can sometimes be the first symptom. People may also have nosebleeds, easy bruising, or other bleeding problems, and weakness from anemia (low red blood cell count) or thrombocytopenia (low platelet count). Other symptoms in advanced stages are shortness of breath, weight loss, discomfort in the abdomen (belly), joint pain and swelling, and fever. Problems with the body’s immune (infection-fighting) system lead to special types of blood problems (anemia, thrombocytopenia) and increased chances for bacterial, fungal, and unusual viral infections.
About one quarter of people have no symptoms. CLL is often found from blood tests done for another reason. These people have too many white blood cells, swollen glands, or enlarged spleen (the spleen makes and stores blood cells). The health care provider may order more blood tests, bone marrow sample, chest x-rays, and computed tomography to determine the stage of CLL.
People with no symptoms may need no treatment, but the health care provider will watch them carefully. The health care provider will suggest seeing a hematologist, a specialist in leukemia treatment.
People with symptoms receive chemotherapy. Chemotherapy can cause side effects, including nausea, vomiting, diarrhea, mouth sores, weakness, bleeding, greater chance of getting more infections, and other cancers.
Radiation therapy to the spleen and lymphoid tissue can help control some symptoms. Sometimes the spleen is removed, but this doesn’t affect normal living.
Bone marrow transplantation may cure younger people with CLL. Transplantation replaces diseased marrow with healthy marrow. It is not commonly done in CLL due to the advanced age of most patients.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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