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Chronic Lymphocytic Leukaemia

When cells begin to multiply uncontrollably, cancer develops. Cancerous cells can develop in almost any portion of the body and spread to other organs.


The most frequent form of leukaemia in adults is chronic lymphocytic leukaemia (CLL). It's a particular sort of cancer that develops in the bone marrow in cells that eventually become specific lymphocytes, which are white blood cells. Leukaemia cancer cells begin in the bone marrow and go into the blood.


Leukaemia cells frequently develop slowly in CLL. Many people go years without experiencing any symptoms. The lymph nodes, liver, and spleen are among the bodily organs where the cells eventually proliferate and disseminate.




Doctors concur that there appear to be two distinct types of CLL:


  • A kind of CLL has very sluggish growth. Therefore, it can be a while before the patient requires therapy.
  • The second type of CLL progresses more quickly and represents a more dangerous condition.


Although the leukaemia cells of these two varieties resemble each other, lab tests may distinguish between them. The tests search for ZAP-70 and CD38 proteins. Low levels of these proteins in CLL cells are associated with slower growth and an improved long-term prognosis.



Early on, CLL normally does not manifest any symptoms, and it is only possible for a blood test performed for another purpose to detect CLL.


When symptoms appear, they might consist of:


  1. Having frequent infections
  2. Anaemia
  3. Ongoing fatigue
  4. Shortness of breath
  5. Pale complexion
  6. Frequent bruising and bleeding
  7. High body temperature
  8. Night sweats
  9. Inflammation and soreness in your stomach
  10. Enlarged glands in your neck, armpits, or groyne
  11. Unintended loss of weight


If you have any symptoms that are bothersome or persistent, you should see your doctor. It's a good idea to have these symptoms evaluated because they might have reasons other than cancer.




There are 2 distinct methods for categorizing CLL:


  1. The United States uses the Rai system more frequently.
  2. The Binet method is more prevalent in Europe.


These two staging methods, which have both been around for a while, are both useful.


Lymphocytosis is the basis of the Rai system. The patient must possess a significant amount of lymphocytes in both their bone marrow and blood that are unrelated to any other condition.

Based on the findings of blood tests and a physical assessment, this method classifies CLL into 5 stages:

  • Rai stage 0: This includes lymphocytosis, no splenic or liver enlargement, and red blood cell and blood platelet counts that are close to normal.
  • Rai stage I: Red blood cell and platelet levels are close to normal; lymphocytosis; swollen lymph nodes; spleen and liver are not enlarged.
  • Rai stage II: Lymphocytosis, enlarged spleen (and maybe enlarged liver), enlarged lymph nodes, possibly; near-normal red blood cell and platelet levels.
  • Rai stage III: Lymphocytosis, swollen lymph nodes, spleen, or liver, low red blood cell counts (anaemia), and platelet counts that are close to normal are all symptoms of this stage.
  • Rai stage IV: This includes lymphocytosis, swollen lymph nodes, spleen, or liver, low or near-normal red blood cell counts, and low platelet levels.


In the Binet staging method, CLL is categorized according to the number of lymphoid tissue groups (such as the neck, groyne, underarm, spleen, and liver) that are impacted as well as whether or not the patient has anaemia or thrombocytopenia (low blood platelets).

  • Binet stage A: There is no anaemia or thrombocytopenia, and less than three lymphoid tissue regions are enlarged.
  • Binet stage B: No anaemia or thrombocytopenia, 3 or more enlarged lymphoid tissue regions.
  • Binet stage C: Thrombocytopenia and/or anaemia are present. It is possible to increase any quantity of lymphoid tissue regions.




The medical professional will do a physical examination and inquire about your symptoms.


Testing for CLL could involve:


  1. CBC with blood cell differential, or complete blood count.
  2. White blood cell analysis using flow cytometry.
  3. Genes or chromosomes can be examined and counted using fluorescent in situ hybridization (FISH). This examination might aid in the diagnosis of CLL or help with therapy planning.
  4. A Bone Marrow examination

There may also be tests that examine DNA alterations within cancer cells. Your physician decides on your therapy with the aid of the results from these tests and staging tests.


Risk factors:


Doctors typically don't understand what causes CLL. If any of the following apply to you: You have CLL in a parent, sibling, or kid.


  • You're at least middle age
  • You are a person of colour


Your risk of developing CLL may also increase if you were subjected to Agent Orange, a pesticide that was widely employed during the Vietnam War.



Your chronic lymphocytic leukaemia treatment options will depend on several variables, including the stage of your malignancy if you are showing symptoms, your general health, and your preferences.


Chemo Immunotherapy: Chemotherapy and Immunotherapy in the form of CD20 directed monoclonal antibody are effective form of therapy.


Targeted therapy: This therapy works at specific targets in the leukemic cells, inhibiting their proliferation and bring relief to patients. Ibrutinib and acalabrutinib are examples.


The treatments mentioned are either used separately or in combination.




The most prevalent kind of leukaemia in adults is chronic lymphocytic leukaemia. Your bone marrow and blood cells are both affected. As you get older, your chances of developing CLL increase; most people with CLL are diagnosed in their 70s. There are several therapies for CLL. Many people with CLL who get therapy go for extended stretches without experiencing any symptoms or health issues.

Dr. Amarendra Amar
Cancer Care
Meet The Doctor
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