Treatment is not always required and the patient may just be followed up as an outpatient on a regular basis, sometimes for many years, with no need for further action.
Older people with early stage CLL have a normal life expectancy. Treatment in the form of chemotherapy will be required for those who are unwell or who have many enlarged lymph glands, or who become significantly anaemic.
Chemotherapy is usually given in the form of tablets (usually a medicine called chlorambucil (Leukeran)). Other chemotherapy drugs such as fludarabine (Fludara) (may be used in late stage disease. General bone marrow production of blood cells can occur in more advanced CLL (bone marrow failure) in which steroid treatment with prednisolone (eg Deltacortril) usually allows the bone marrow to recover. Milder degrees of bone marrow failure might adequately be controlled by periodic blood transfusion.
X-ray treatment (radiotherapy) can be given locally, to swollen lymph nodes, or in small repeated doses to the whole body. Infections are more common in people with CLL and need to be diagnosed early and treated vigorously.
Sometimes the spleen, which is also part of the body’s immune system swells up so much in CLL that it gives rise to pain, or it causes a type of anaemia to develop in which the red cells of the blood (oxygen-carrying cells) become fragile, leading to further anaemia. These problems may justify the surgical removal of the spleen.
Bone marrow transplantation may be considered for those patients who are less than 45 years of age and who have an aggressive form of the disease.
Wednesday, September 9, 2009
How is chronic lymphocytic leukaemia diagnosed?
Often the condition is diagnosed by chance when blood tests are being performed for other reasons.
Although a blood test may give doctors the diagnosis, a bone marrow test is usually done to confirm the diagnosis. Special tests are performed on these samples to help classify the leukaemia as this will influence the kind of treatment required.
Scans and X-rays may also be performed in order to help doctors decide on the best treatment.
Although a blood test may give doctors the diagnosis, a bone marrow test is usually done to confirm the diagnosis. Special tests are performed on these samples to help classify the leukaemia as this will influence the kind of treatment required.
Scans and X-rays may also be performed in order to help doctors decide on the best treatment.
What are the symptoms of chronic lymphocytic leukaemia?
In addition to the symptoms mentioned above which are common to all forms of leukaemia, specific signs of the disease are:
painless enlargement of the lymph glands especially in the neck, armpits and groin.
lymph glands in deeper parts of the body may need special scans for diagnosis.
sometimes an enlarged spleen (located in the left upper quadrant of the abdomen) may cause discomfort or pain.
painless enlargement of the lymph glands especially in the neck, armpits and groin.
lymph glands in deeper parts of the body may need special scans for diagnosis.
sometimes an enlarged spleen (located in the left upper quadrant of the abdomen) may cause discomfort or pain.
What is chronic lymphocytic leukaemia?
Chronic lymphocytic leukaemia (CLL) is the commonest type of leukaemia with 3000 to 4000 new cases diagnosed each year in the UK. It is a form of chronic leukaemia characterised by an increased number of lymphocytes, which make up one of the main sub-groups of white cells in the blood. Despite their increased numbers these lymphocytes lack the normal ability of responding to infection by the production of antibodies, so compromising the immune system of the affected person.
CLL is rarely found in people under the age of 40 - the peak age is 65. It is twice as common in men than in women. There are no obvious causes known for CLL.
CLL is rarely found in people under the age of 40 - the peak age is 65. It is twice as common in men than in women. There are no obvious causes known for CLL.
What are the symptoms of chronic leukaemia?
It is possible to have chronic leukaemia for months or even years without knowing it.
The symptoms are varied, but many people notice:
tiredness (due to anaemia)
bruising easily (often without having had any blow or fall)
repeated infections
enlarged lymph glands
weight loss
night sweats
fever.
The symptoms are varied, but many people notice:
tiredness (due to anaemia)
bruising easily (often without having had any blow or fall)
repeated infections
enlarged lymph glands
weight loss
night sweats
fever.
What is chronic leukaemia?
The white cells are part of the body’s immune system, and there are several sub-groups of white cells that have different sorts of roles in recognising and dealing with ‘invaders’ such as bacteria and viruses as well as other types of foreign protein.
All of the blood cells originate in the bone marrow and leukaemia (blood cancer) is a disease where the bone marrow produces large numbers of abnormal white cells. This means that the normal marrow is pushed into smaller and smaller areas. This results in fewer normal cells being produced and gives rise to some of the symptoms.
There are many types of leukaemia, each of which is classified according to the exact cell type affected by the disease.
Chronic leukaemia is a slowly progressive form of leukaemia and tends to involve more mature cell types. It may not need treatment immediately, but if treatment is required it is usually chemotherapy, given in the form of tablets.
The cause of leukaemia is not known.
All of the blood cells originate in the bone marrow and leukaemia (blood cancer) is a disease where the bone marrow produces large numbers of abnormal white cells. This means that the normal marrow is pushed into smaller and smaller areas. This results in fewer normal cells being produced and gives rise to some of the symptoms.
There are many types of leukaemia, each of which is classified according to the exact cell type affected by the disease.
Chronic leukaemia is a slowly progressive form of leukaemia and tends to involve more mature cell types. It may not need treatment immediately, but if treatment is required it is usually chemotherapy, given in the form of tablets.
The cause of leukaemia is not known.
What your doctor is looking for
Samples collected with cancer blood tests or other tests of urine, fluid or tissue are analyzed in a lab for signs of cancer. The samples may show cancer cells, proteins or other substances made by the cancer. Blood and urine tests can also give your doctor an idea of how well your organs are functioning and if they've been affected by cancer.
Examples of blood and urine tests used to diagnose cancer include:
Complete blood count (CBC). This common blood test measures the amount of various types of blood cells in a sample of your blood. Blood cancers may be detected using this test if too many or too few of a type of blood cell or abnormal cells are found. A bone marrow biopsy may help confirm a diagnosis of a blood cancer.
Urine cytology. Examining a urine sample under a microscope may reveal cancer cells that could come from the bladder, ureters or kidneys.
Blood protein testing. A test to examine various proteins in your blood (electrophoresis) can aid in detecting certain abnormal immune system proteins (immunoglobulins) that are sometimes elevated in people with multiple myeloma. Other tests, such as a bone marrow biopsy, are used to confirm a suspected diagnosis.
Tumor marker tests. Tumor markers are chemicals made by tumor cells that can be detected in your blood. But tumor makers are also produced by some normal cells in your body and levels may be significantly elevated in noncancerous conditions. This limits the potential for tumor marker tests to help in diagnosing cancer.
The best ways to use tumor markers in diagnosing cancer hasn't been determined. And the use of some tumor marker tests is controversial. Examples of tumor markers include prostate-specific antigen (PSA) for prostate cancer, cancer antigen 125 (CA 125) for ovarian cancer, calcitonin for medullary thyroid cancer, alpha-fetoprotein (AFP) for liver cancer and human chorionic gonadotropin (HCG) for germ cell tumors, such as testicular cancer and ovarian cancer.
Examples of blood and urine tests used to diagnose cancer include:
Complete blood count (CBC). This common blood test measures the amount of various types of blood cells in a sample of your blood. Blood cancers may be detected using this test if too many or too few of a type of blood cell or abnormal cells are found. A bone marrow biopsy may help confirm a diagnosis of a blood cancer.
Urine cytology. Examining a urine sample under a microscope may reveal cancer cells that could come from the bladder, ureters or kidneys.
Blood protein testing. A test to examine various proteins in your blood (electrophoresis) can aid in detecting certain abnormal immune system proteins (immunoglobulins) that are sometimes elevated in people with multiple myeloma. Other tests, such as a bone marrow biopsy, are used to confirm a suspected diagnosis.
Tumor marker tests. Tumor markers are chemicals made by tumor cells that can be detected in your blood. But tumor makers are also produced by some normal cells in your body and levels may be significantly elevated in noncancerous conditions. This limits the potential for tumor marker tests to help in diagnosing cancer.
The best ways to use tumor markers in diagnosing cancer hasn't been determined. And the use of some tumor marker tests is controversial. Examples of tumor markers include prostate-specific antigen (PSA) for prostate cancer, cancer antigen 125 (CA 125) for ovarian cancer, calcitonin for medullary thyroid cancer, alpha-fetoprotein (AFP) for liver cancer and human chorionic gonadotropin (HCG) for germ cell tumors, such as testicular cancer and ovarian cancer.
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