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Chronic lymphocytic leukaemia

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Chronic lymphocytic leukaemia


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Haematological, lymphatic
Although it is the most common form of adult leukaemia, CLL (Chronic Lymphocytic Leukaemia) is rare, developing mostly in people over 60 years old. It is seen more often in men than women, and occurs in most races. Many people with CLL will not develop the disease to the point where it needs treatment, but in most it will eventually need to be treated.

CLL is a slow growing type of cancer where a type of white blood - B lymphocytes - becomes abnormal. There are too many cells and when they multiply they are not fully developed and so do not work properly. These abnormal cells replace the normal white cells and take over the bone marrow. This can mean too few working blood cells are being created by the body; this can include red blood cells, white cells and platelets. CLL can have other effects such as interfering with the immune system. Most, but not all, cases of CLL that eventually need treatment develop slowly over several years.

Diagnosis is often from a routine blood test. At the early stage of diagnosis, CLL patients may have few or no symptoms, more advanced patients will need treatment sooner. CLL cannot be cured, so the aim of treatment is to get a remission for the patient, when for a time the cancer is under control. When the CLL develops it will need treating again after the period of remission. With some patients, the CLL will contribute to their death.

People with CLL can have various symptoms, but none of the symptoms mean that a person has CLL; there are other causes. For example;

  • Tiredness
  • Lack of energy
  • Many infections
  • Enlarged lymph nodes (neck, armpits, groin)
  • Feeling full all the time
  • Night sweats
  • Unplanned weight loss, loss of appetite.


The signs that a person will need treatment soon include;

  • A fast growing number of the B-lymphocytes,
  • The number of places where lymph nodes are involved,
  • How large the lymph nodes are,
  • Problems with the immune system,
  • Night sweats,
  • Severe fatigue.

Most patients will be in 'watch and wait' (w & w, or watchful waiting) for some time. There is no advantage to the patient in treating before the CLL makes this necessary. This w & w period is hard on the patient and can be difficult to explain to friends and family. Many people are well, and are able to continue the lifestyle they are used to, including full time work.
During w & w, your doctor (or the hospital clinic) will check your lymph nodes, liver and spleen at regular intervals. Regular blood tests will monitor how fast the B cells are increasing. Always keep your appointments. If you need transport, contact your GP.
If you need treatment, your doctor will judge how fit you are overall. Some of the treatments that give the best results are very hard on your system. A fit person may have one type of treatment, a less fit person may have another type of treatment.

Treatments are with anti-cancer chemotherapy drugs. You may also receive steroids and/or a monoclonal antibody. A monoclonal antibody is a drug that targets the walls of the CLL cells, so that your own body attacks them.
With all areas of CLL treatment, there are advances happening all the time and what clinics recommend can change rapidly as more is known.

CLL is not a lifestyle cancer. It is not caused by smoking, obesity, drinking alcohol, chemicals or any particular job. You have not caused your CLL, there is nothing to feel guilty about.

Keeping Healthy

If you smoke, give up – see give up smoking section. Many CLL patients die from lung infections, get help; ask at the Pharmacy or your GP.

  • Have a healthy lifestylefit people cope with cancer treatment better.

  • Keep your weight in the right range.

  • Eat all the protein, vitamins and minerals you need.

  • Do some exercise everyday; do what suits you and your ability; keep active.

  • Treat yourself occasionally.

Meeting your Specialist

If you have CLL, it is easy to feel out of control. Here are some questions that you might ask your doctor. Some people say that the more they understand, the more in control they feel.

  • How does the CLL affect my life expectancy?

  • How will my doctor and I know if or when the CLL needs treating?

  • If I need treatment, what treatment would you recommend? How long would I take the treatment for, and what are the side effects likely to be?

  • Are there symptoms I should look out for which mean that I have to contact a doctor straight away?

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The production costs associated with this piece have been sponsored by Roche for the advancement and support of medical, scientific and patient initiatives.

RXUKMABO00172 December 2010