Chronic Lymphocytic Leukemia (CLL)

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After completing a thorough lab analysis of your recent biopsy, a specialized doctor called a pathologist reported a diagnosis of chronic lymphocytic leukemia (CLL), the most common form of leukemia in adults that affects mostly those over the age of 60.

About the Condition

Leuk Diag 12-21-09The soft inner tissue that fills the cavities of bones is called bone marrow. In adults, certain bones such as the skull, shoulder blades, ribs, pelvis and vertebrae (backbones) contain red bone marrow, which is the site of the body’s blood stem cells. These cells develop into blood-forming cells that then produce various components of the blood such as red and white blood cells and platelets. (Blood stem cells are not the same as embryonic stem cells.)

Lymphocytes are a type of white blood cell made in the bone marrow that fight infection and includes B- and T-cells and natural killer cells. Chronic lymphocytic leukemia is cancer that occurs when lymphocytes in the bone marrow do not proliferate, mature and expire in a normal manner. The extra cells that result can spread beyond the bone marrow to lymph nodes and organs such as the spleen or liver, which can become enlarged.

The term chronic refers to the fact that the disease forms in cells that appear mature, even though they are not truly normal. Many patients with CLL have no adverse effects; some may experience symptoms that include fatigue, fever, night sweats, swollen lymph nodes, upper abdominal discomfort, increased risk of infection and anemia (reduced red blood cell count).

CLL can be slow- or fast-growing. There are five general stages of the disease — 0, I, II, III and IV — based on blood chemistry measurements and the extent of swelling in the lymph nodes, liver and spleen. Your doctor can tell you more about your cancer stage.

Treatment Options

Deciding on a treatment plan for CLL can be complex and depends upon a variety of factors such as your age, general health condition, stage of cancer and personal preferences. The following treatment possibilities are available:

Watchful Waiting – Some patients with slow-growing CLL decide not to pursue active therapy for their cancer but rather adopt a “watch and wait” tactic, avoiding the side effects of standard treatments.

Chemotherapy – The use of anti-cancer drugs, or chemotherapy, provides a way to kill leukemia cells systemically (throughout the body) via the bloodstream. Often a combination of several drugs is given, which varies based on the stage of cancer.

Biologic Therapy – In certain cases, therapy that employs man-made biologics (i.e., synthetic proteins) such as rituximab and alemtuzumab is used to treat CLL. These biologics are called monoclonal antibodies and work by targeting specific proteins found on cancerous cells.

Radiation Therapy – Radiation therapy is not a main treatment for CLL, but does provide a way to reduce bone pain and discomfort caused by enlarged lymph nodes or organs. External beam radiation is generally used, in which a high energy X-ray machine directs radiation at the affected area(s).

Surgery – In rare cases when an enlarged spleen from CLL presses on other organs and causes pain, a splenectomy may be performed to remove it, which does not cure the leukemia but can improve blood cell counts.

You may also consider participating in clinical trials. These investigative studies help doctors learn about new treatments and better ways to use established treatments.

What You Can Do

You can choose to take an active role in your health and well-being. Learn as much as you can about your condition and have a list of questions ready each time you meet with your doctor. Join a cancer support group, and talk with your family, friends, clergyperson or counselor as you feel comfortable. Also be sure to eat well including fruits and vegetables, get plenty of sleep and stay as active as you can.

Additional Resources

American Cancer Society, 800.227.2345,
The Leukemia & Lymphoma Society, 800.955.4572,

This patient resource sheet is provided to you as a service of CBLPath® and is intended for information purposes only. It may not fully describe all aspects of your diagnosis and is not meant to serve as medical advice or a substitute for professional medical care. Your physician can provide you with a thorough explanation of your diagnosis and appropriate treatment options, which may vary. Only you and your physician can determine your best treatment plan.

Updated 8.12