Q: What are the ongoing symptoms and prognosis of chronic lymphocytic leukemia? Are there any cures for this? I understand the disease is slow to progress but how many years will it progress before medication or chemotherapy will be required?
A: Chronic lymphocytic leukemia ( CLL) is a form of cancer of the blood and bone marrow. The condition commonly affects older individuals and is slow to progress. While some patients may not have early symptoms, others may present with fever, night sweats, weight loss, enlarged lymph nodes that are painless, upper left abdominal pain, and more.
It isn’t completely understood what mechanism occurs to cause the condition but there is a known genetic mutation in the DNA of blood producing cells in the majority of, but not all, patients with CLL. The mutation causes blood cells to produce ineffective and abnormal lymphocytes, a type of white blood cell that helps the body fight infection. The abnormal lymphocytes live and multiply (whereas normal lymphocytes would die), accumulate in the blood and in specific organs, and interfere with the normal production of blood cells. Leukemia cells tend to build up over time.
Those conditions that may increase an individual’s risk for CLL include having a family history of the disorder, being older than 60, being exposed to specific insecticides and herbicides including agent orange, and more. Individuals so diagnosed may have other immune system issues, suffer from frequent infections of the upper and lower respiratory tract, or experience other forms of cancer such as melanoma and skin cancer.
Diagnosis may be determined from lab testing that includes a complete blood count, bone marrow biopsy, CT, flow cytometry, and more. Two separate staging systems have been determined, with each falling into the category of early, intermediate, or advanced. Once identified (which classifies the progression of the disorder), appropriate treatment options may then be determined.
There appears to be two types of CLL. The first is slow growing and the other is more serious, growing at a faster rate. With acute leukemia, bone marrow cells are unable to mature properly. The acute type responds well to treatment and many patients can be cured. While the cells from these two types resemble each other, lab testing and physical examinations every three months during the first year of diagnosis differentiates them and can help determine whether the CLL is slow or fast growing. Those individuals in the early stages of CLL may not require treatment at all. In fact, ongoing clinical trials are geared toward determining whether early treatment is actually helpful; and while it make take an extended period of time for such a determination, this represents progress in the overall treatment picture. If the condition is more advanced, treatment options may include chemotherapy, other drug therapy, and bone marrow stem cell transplants.
Without knowing the extent of the CLL to which you refer, I cannot answer your question. This is something that should be brought to the oncologist’s attention so you can receive the answers you need. In the interim and on the home front, such things as massage, yoga, meditation and exercise may help a patient cope with the intense fatigue that accompanies the condition.
