What is CLL?
Chronic lymphocytic leukaemia (CLL) is the most common type of leukaemia in New Zealand, with approximately 300 people diagnosed every year. CLL is more common with age. The majority of people are over 50 years old when they are diagnosed.
Chronic lymphocytic leukaemia (CLL) is a type of slow-growing (chronic) leukaemia that affects developing B-lymphocytes (a type of white blood cell). Under normal conditions they produce antibodies that help protect our bodies against infection and disease. In people with CLL, B-lymphocytes undergo a malignant (cancerous) change and become leukaemic cells that grow uncontrollably.
CLL usually develops and progresses slowly over many months or years. However, in some cases people may need to be treated soon after they are diagnosed.
Signs and symptoms
Symptoms of CLL vary from person to person. Many people have no symptoms when they are first diagnosed. Some people will have symptoms which may include:
- Frequent or repeated infections
- Tiredness and fatigue
- Weakness
- Shortness of breath
- Bleeding or bruising more easily
- Red or purple pinhead-sized spots on your skin
- Swollen lymph nodes
- Recurrent drenching sweats at night
- Unexplained weight loss.
Causes
The cause of chronic lymphocytic leukaemia is unknown and there are no clear risk factors. Studies show that there is a slightly higher rate of CLL and related conditions among first-degree relatives (parents, siblings and children) of people with CLL. However, this risk is small, and CLL is not thought to benefit from early detection or treatment.
CLL is not contagious; you cannot catch CLL by being in contact with someone who has it.
Treatment
Treatment for CLL is based on several factors including the state of the disease, whether the patients have symptoms, how quickly the disease is progressing and the age of the patient.
It is common for people with CLL to be monitored by their doctor and only start treatment when they start experiencing certain symptoms. This could be many years after being diagnosed, or it may never need treatment. Some people may have to start treatment sooner.
Active monitoring means that your disease does not need any treatment at this point in time. It does not mean that your disease is too advanced to treat, or that you are too old for treatment.
Ongoing monitoring and regular check-ups will likely include routine blood tests and physical examinations. The timing of doctor visits and tests may vary from person to person.
While being monitored you can still be active and maintain healthy habits. These include:
- Regular exercise
- Eating a healthy diet
- Reducing stress levels
- Stopping smoking
- Stopping or limiting alcohol intake
- Using a high-factor sunscreen and wear a hat while outdoors, to protect against skin cancers
- Keeping up to date with relevant vaccinations (e.g. influenza).
It is important to be aware of symptoms that may indicate your CLL getting worse or the need for treatment. These may include:
- Severe fatigue
- Weight loss
- Drenching night sweats
- Lymph nodes rapidly swelling/increasing in size
- A blood test showing a reduction of red blood cells, neutrophils and/or platelets
A rising lymphocyte count on its own does not usually mean treatment is required so long as the remainder of the full blood count remains normal. Often, an infection can cause a temporary rise in lymphocytes, but this does not necessarily imply your CLL is deteriorating.
The aim of treatment is to improve your symptoms and/or improve blood cell counts and prolong survival with a good quality of life. The treatments of CLL have changed over the last 20 years and are likely to continue to improve as more research is done. Currently the main treatment options for CLL are:
- Chemotherapy
- Immunotherapy
- Targeted therapy
- Stem Cell Transplant
- Radiotherapy
- Clinical Trials
For more information visit our Treatment page.
