Chronic Lymphocytic Leukaemia

What is chronic lymphocytic leukaemia (CLL)?

Chronic lymphocytic leukaemia, also known as CLL, is a type of leukaemia and is a variety of cancer that impinges on the blood. CLL is the most common type of leukaemia and around 2,400 people are diagnosed with the condition every year in the UK. CLL usually develops gradually and some people may not require immediate treatment, but this is not always the case. Leukaemia causes abnormal white blood cells to form and people with CLL produce too many lymphocytes, which means that the cells are immature and do not function properly. As the condition progresses the immature lymphocytes collect in the lymphatic system, causing the lymph nodes to become swollen.

CLL is very rare in people below the age of 40 and it tends to affect men more than women.

What causes CLL?

The exact cause of CLL is unknown but some risk factors have been identified. These include:

• Age: CLL is more common among people over the age of 60
• Gender: CLL is more common in men than women
• Race and ethnicity: CLL is most common among European people and is very rare among Asian people

Symptoms of chronic lymphocytic leukaemia

CLL develops gradually in many cases and it can take a long time for symptoms to develop. Symptoms that may be associated with CLL include:

• Tiredness and generally feeling unwell
• Infections: people with CLL tend to be more susceptible to infections and illnesses
• Swollen lymph nodes (this does not usually cause pain)
• Bruising easily
• Headaches, breathlessness and tiredness: these are associated with anaemia, a lack of red blood cells
• Weight loss
• A swelling or lump in the upper abdomen (this will be on the left hand-side and is caused by the spleen being enlarged)

How is CLL diagnosed?

If you have symptoms that are consistent with CLL or abnormal blood tests, your GP will refer you to a specialist haematologist for further tests. At the hospital, tests carried out may include further blood tests, a chest X-ray, bone marrow and lymph node biopsy tests and a CT scan.

What treatments are used for CLL?

The most common treatment for CLL is chemotherapy and, in a proportion of cases where no symptoms have developed, a doctor may advise against immediate treatment. Radiotherapy may be recommended for patients with very swollen lymph nodes and surgery may be carried out if the spleen is enlarged.

What is the outlook for people with CLL?

The outlook depends on a number of factors, including how early the cancer is diagnosed, how quickly it develops and how it responds to treatment. CLL cannot usually be cured, but it can be managed effectively in many cases. 44 percent of men and 52 percent of women with CLL survive more than 5 years after diagnosis.

Living with CLL

Living with chronic lymphocytic leukaemia is very difficult. You may experience a mixture of emotions and struggle to come to terms with the fact that you have cancer. Your care team will cater for all phases of your care, including emotional support, but if you need more information or advice, you can contact one of the UK's well-founded cancer charities.