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What is Chronic Lymphocytic Leukemia?

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Published on July 23, 2020

Common Signs and Symptoms of CLL

While people present as asymptomatic, many may be unaware that they have chronic lymphocytic leukemia (CLL). Prior to routine blood tests, only some will develop symptoms of progression early in the disease course.
 
Dr. Nitin Jain, an Associate Professor in Department of Leukemia at The University of Texas MD Anderson Cancer Center, offers an explanation of how CLL, a cancer of the white blood cells, manifests in the body, and some early signs and symptoms. Dr. Jain describes how the cells become cancerous, what to look for, and how CLL is typically diagnosed. He also discusses strategies for managing CLL and treatment options. It is his hope that patients can continue to live a normal life after diagnosis.

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Transcript | What is Chronic Lymphocytic Leukemia?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

 Dr. Nitin Jain:

So CLL stands for chronic lymphocytic leukemia. So this is a disease of what is called white blood cells. All of us have white blood cells, which perform a variety of function of our body, including fighting infection. But one of the white blood cells, specifically called B cells. Those help make antibodies for us to fight infections, but in some patients, those B cells become cancerous. And many times when they become cancerous, they start multiplying in the bone marrow, in the lymph nodes, and then many times they spill out in the blood. So as a patient, your doctor may do... You're feeling fine. You just go to a general medical examination and then they say the blood counts are elevated. And when they do this special testing, they see these abnormal cancer cells, which are derived from these blood cells called B cells circulating in the blood. And that's when they will diagnose you to have chronic lymphocytic leukemia. So again, it's a disorder, a cancer, of the bone marrow of the lymph nodes, where the cancer cells are derived from the normal white blood cells, which have become now abnormal.

So most patients in our practice, actually, when they're diagnosed with CLL may not know they have CLL. So many times the doctor that you go for annual physical examination to a doctor, they do a blood count and your white blood cell count may be elevated. And that specifically the doctor may say that your lymphocytes are elevated. And that's, I think if someone is about 55, 60 years of age, and if that's one of the most common reason for that would be CLL. So, that would be called someone called asymptomatic. So they had no idea. They just go in for a routine physical and the blood counts are abnormal. Sometimes as the disease progresses, the patients can develop symptoms, certainly. Symptoms coming from enlarged lymph nodes. So lymph nodes are present in the neck, in the armpits and the groin area, and the patients can start feeling some of those lymph nodes themselves.

Sometimes they can also cause discomfort. And in severe cases, as the CLL progresses, patients can have night sweats and night sweats can also be present early on in the course of disease actually. Patients can have weight loss and those will be other symptoms which can develop as kind of the time goes by. Plus, if their blood counts become abnormal, which again, generally happens with the later part of the disease. So then they can develop more shortness of breath from low hemoglobin. They can develop increased bleeding issues from low platelet count. But again, those are less common in the early part of the disease. Those things will occur generally in the later part of the disease.

 Well, I mean, I would say that, thankfully with the new drugs we have for patients with CLL, I think majority of the patients with CLL, I hope that who are diagnosed today can live a normal lifespan, which they would have if they didn't have CLL. So I think, yes, there are some groups of patients which have high risk CLL, which can be difficult to control, but for majority of the patients at the time of diagnosis, they are just being recommended to watch and wait approach.

And again, even if the treatment is needed, there are very, very effective therapies available these days and more to come in the next few years. So I would say that the goal, and I hope that's the goal for me and other skilled investigators is to make CLL like a chronic disease. Like if you have diabetes, if you have a hypertension, you take a medicine for controlling the disease and as you do that, you can live a normal life. Certainly CLL is more serious than that, but at the same time with the new drugs, which are very effective, I hope that for majority of the patients, they can live a normal lifespan after getting a diagnosis of CLL.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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