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What is CLL? An Overview of the Disease’s Effect on the Body

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Published on December 4, 2018

Many patients want to know what chronic lymphocytic leukemia (CLL) is and how it will develop over time. CLL experts Dr. Philip Thompson, from The University of Texas MD Anderson Cancer Center, and Dr. Susan Leclair, from, University of Massachusetts, Dartmouth, explain how the condition manifests in the body, what it looks like on a cellular level and potential complications patients may experience from the disease.Watch now to learn more.

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Transcript | What Is CLL? An Overview of the Disease’s Effect on the Body

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.

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.

Andrew Schorr:

Help us understand.  What is it?  You've looked at a million blood tests and your students, what do you see? What is it?  

This is a chronic condition. These cells look reasonably at times, normal.  They may not work well, but they can look normal.  You typically have a high white count.  Well, what is high?  High could be not high at all.  

It could be hugely high. The high white count we talk about is of a specific type of cell called a lymphocyte in particular a subtype of lymphocyte most common, which is called B lymphocytes.  But you will get an increase in that one cell line.  Your red cells will probably be fine in the beginning. Your platelets will probably be fine in the beginning.  No one knows. There's so many different variations and routes you can take, it's hard for me to say that those will be fine forever, but in the beginning there's usually just an increased number of these typically B, typically looking pretty okay cells.  The problem is their function doesn't work.  

Why doesn't their function work?  Oh, if I had that I would be on my way to Oslo to get a Nobel Prize.  

Somehow, somewhere in the course of your life a mistake is made in a cell, in your genes, and from that stumbles a clone of cells that look kind of okay but don't work okay.  That's what we see.  That's how it happens.  What genetic mutations?  What are we up to now?  Fifty of them that might be involved in this, so in fact no one will know that answer for a while.  

So even—some patients, even with early-stage CLL where it's otherwise causing no problems, their other blood counts are normal, they can have an increased risk of infection. They can also have an increased risk of things like skin cancer where immune system is surveillance is.  

And the second thing that can happen is they can accumulate in lymph nodes, they can accumulate in the liver and the spleen, so you can have enlargement of lymph nodes in your neck or your armpits.  The spleen can become enlarged.  

And then the third thing that can happen is the CLL cells can also live in the bone marrow, and they can crowd out the normal bone marrow.  And essentially I sometimes describe it to patients as you've got a factory for making cars, which is your blood cells, but it's piled high with junk and there's just no room to make the normal blood cells.  And so you can end up with anemia, which is not enough red blood cell and therefore not have enough oxygen-carrying capacity in your blood. People can feel tired, short of breath when they exert themselves.  

And then you also mentioned the platelets.  So the platelets are the things that clot the blood.  If you don't have enough of them you may notice some easy bruising and bleeding. And so I mentioned earlier that many patients at diagnosis don't need to have a bone marrow biopsy because we can diagnose CLL without a bone marrow biopsy.  

But if with we get to the point where patients are anemic or patients have a low platelet count, that can be a reason that we need to treat a patient.  And we would always do a bone marrow biopsy before treatment, and we would do it if we needed to investigate why a patient was anemic or had the low platelet count.  

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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