Chronic lymphocytic leukemia begins with abnormal development of lymphocytes, a type of white blood cells in the lymph glands. Rather than maturing in a normal manner, these cells continue to multiply and produce an excessive amount of defective (leukemic) cells.
After some time – perhaps a few years – leukemic cells reduce the number of normal white cells in the lymph glands and reduce the ability of healthy cells to produce antibodies against infection.
Leukemic cells are also transfered from the lymph glands to the bloodstream and from the bloodstream to various parts of the body such as the spleen, liver and bone marrow. Because they increasingly attack bone marrow, they interfere with the production of red and white cells and platelets in the bone marrow. The lack of these cells in the dawning stages of the disease causes anemia, susceptibility to infection, and bleeding.
Symptoms may occur five or more years after the initial cellular defect, although the disease may sometimes also be detected before routine blood test. In some cases, the first sign of illness is an increase of the lymph glands – from the side to the neck, under the abdomen or the groin – or the enlargement of the spleen, which feels like tightness or “fullness” in the upper left of the abdominal cavity. In other cases, the first symptoms are symptoms of anemia or frequent attacks of severe infections, e.g. lung inflammation. In some cases, people generally feel weak, have low appetite and lose weight, their temperature is high, they sweat, and these are the first signs of the disease.
In very advanced stages of disease, lack of platelets will cause prolonged bleeding from the wound and spontaneous bleeding is also possible, e.g. from very sensitive mucous membranes and mouth.
Like other types of leukemia, chronic lymphocytic leukemia is very rare and affects only 1 in 20,000 people. It occurs almost exclusively in people over 60 years old. The disease is incurable, but modern treatment methods allow the patient to live a normal life long after the diagnosis is made.
Although chronic lymphocytic leukemia is incurable, in some patients and without therapy, symptoms do not develop up to five years after diagnosis. Symptoms can be considerably alleviated by modern treatment, thus extending life expectancy for another 10 years.
What to do?
Anyone with persistent enlarged glands, permanently elevated temperature, or frequent infections must contact a doctor who will refer him to the blood test. Laboratory analysis will show whether this is a chronic lymphocytic leukemia or not. Sometimes a bone marrow biopsy is performed before setting a definitive diagnosis.
If the disease is discovered at the very beginning stage, the patient’s doctor will perform examinations every six months, taking a blood sample. As soon as the first symptoms appear, the patient will usually be cured outpatient. If strong anemia is already present, a short stay in the hospital for blood transfusion may be required.
Chronic lymphocytic leukemia is commonly treated with cytostatics (anti-cancer drugs). Tablets of this drug are taken for at least a few months, or perhaps up to one year, to reduce the anemia and reduce the gland. If the glands are greatly increased, corticosteroids can also be administered or radiotherapy may be used. Large doses of antibiotics are given to suppress the infection, and anemia is treated with blood transfusion. With combination therapy of drugs, most patients can live a fairly normal life five to ten years after diagnosing. But, eventually, the disease can become resistant to all forms of treatment.