Chronic lymphoblastic leukemia (CLL) is a cancer of blood cells, which affects white blood cells, called lymphocytes, which are responsible for the body’s natural defense in fighting infections.
This type of leukemia, also known as chronic lymphocytic leukemia, is characterized by the uncontrolled production of abnormal lymphocytes in the bone marrow that pass into the bloodstream, which can accumulate in some organs and lead to symptoms such as enlarged lymph nodes, loss of weight and excessive tiredness, for example.
CLL is normally diagnosed after the age of 70, this is because the disease progresses slowly, with symptoms generally being noticed when the disease is already at a more advanced stage. Because of the delay in the onset of symptoms, the disease is normally identified during routine blood tests, mainly blood counts, in which an increase in the number of lymphocytes can be identified.
Symptoms of chronic lymphocytic leukemia
The main symptoms of chronic lymphoblastic leukemia are:
- Bumps that can appear anywhere on the body, being most common on the neck, armpits or groin;
- Excessive tiredness or weakness;
- Shortness of breathe;
- Pale skin;
- Frequent bleeding or bruising;
- Enlargement of the spleen, also called splenomegaly;
- Abdominal pain, due to enlarged liver;
- Feeling of a full stomach, even after eating little;
- Swelling in the belly;
- Night sweats;
- Weight loss;
- Fever or chills.
Furthermore, it is common for people to experience recurring skin, urine or lung infections, since lymphocytes, which are responsible for producing antibodies that help fight infections, are not functioning properly.
CLL develops over months or years and, therefore, symptoms appear gradually, with the disease often being identified when it is already at a more advanced stage.
How to confirm the diagnosis
The diagnosis of chronic lymphoblastic leukemia is made by the general practitioner or hematologist through the evaluation of the blood count, which is a blood test that evaluates the number of blood cells.
Generally, in CLL, the blood count shows an increase in the number of lymphocytes, especially B lymphocytes, and leukocytes. See what the blood count reference values are.
Make an appointment with the hematologist in the region closest to you:
Taking care of your health has never been easier!
Additionally, the doctor may order immunophenotyping tests to assess whether the increased number of lymphocytes is caused by CLL or some type of infection in the body.
Another test that your doctor may order to confirm CLL is the FISH test, which allows you to evaluate changes in DNA.
If the doctor confirms CLL, before starting treatment, a bone marrow biopsy, called a myelogram, may be requested to check the CLL stage, monitor the evolution of the disease, and to define the prognosis. This exam may be repeated a few times during treatment. Understand how the myelogram is performed.
Possible causes
The exact cause of chronic lymphocytic leukemia is unknown, however, it occurs due to changes or mutations in the DNA of the cells that produce lymphocytes, which begin to multiply uncontrollably.
Some factors may contribute to the development of CLL, such as:
- Family history of CLL;
- Frequent exposure to chemicals such as benzene;
- Exposure to radiation;
- Smoking habit.
Furthermore, chronic lymphocytic leukemia is more common after the age of 70, but it can also affect adults from the age of 30, and rarely affects children.
How the treatment is carried out
The treatment of chronic lymphoblastic leukemia must be carried out under the guidance of an oncologist or onco-hematologist, and varies according to the stage of the disease, and medical follow-up may be indicated every 3 months, especially in the initial stages and if the person does not present CLL symptoms.
However, when symptoms of CLL are present or the stage of the disease is more advanced, the doctor may recommend treatment with:
- Chemotherapywith fludarabine, cyclophosphamide, clorambucil or bendamustine;
- Corticosteroidssuch as prednisone, methylprednisolone, or dexamethasone;
- Immunotherapywith monoclonal antibodies, such as rituximab, ofatumumab, obinutuzumab or alemtuzumab;
- Target therapycom ibrutinib, acalabrutinib, idelalisib, duvelisib or venetoclax;
- Surgerycalled splenectomy, to remove the spleen;
- Radiotherapyto treat swelling in organs such as the spleen, or to reduce bone pain.
Additionally, the doctor may recommend bone marrow transplantation, especially in cases of relapsed CLL or when other treatments have not been effective for the disease to go into remission. See how a bone marrow transplant is performed.
(articleLink_simple:remissao-do-cancer)
