What is Chronic Lymphocytic Leukemia (LLC)?

Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in the western world. CLL shows a strong increase in one type of (malignant) mature white blood cells in the blood: the so-called lymphocytes

These abnormal lymphocytes accumulate not only in the blood, but also in the bone marrow, lymph nodes, spleen and liver. In the Netherlands, CLL is diagnosed each year in 600 to 700 patients. CLL occurs at any age, but especially in patients older than 60 years and more often in men than in women. Up to now, complete cure can not be achieved with chemotherapy at Sheba Medical Cancer Center. However, a temporary disappearance of disease symptoms is possible.

What is CLL?

At CLL there is an increase in malignant mature white blood cells called lymphocytes. In the bone marrow the various components of blood are produced, such as red blood cells, platelets and all kinds of white blood cells, including lymphocytes.

Leukemia (blood cancer) is the collective term for malignant diseases in which there are too many white blood cells in the blood. At CLL the number of abnormal lymphocytes grows: the cells are clones that no longer have a task in the body. The disease is very insidious and is certainly the first years usually without any symptoms

Does CLL often occur?

Chronic lymphocytic leukemia is the most common form of leukemia in the western world. With more than 900 new patients per year, it is still a rare condition. The disease mainly occurs in older people, more often in men than in women. Most people with CLL do not have to be treated immediately. If the disease progresses, it is usually a reason to start the treatment. But there may be reasons to start treating if the disease is less advanced.

Symptoms and Complaints

Very often, a CLL patient has no symptoms and the disease happens to come to light, for example if his blood is examined for something else and there are many or abnormal lymphocytes present. If there are complaints, they are usually not such that the doctor immediately thinks of CLL. The complaints can also occur in many other conditions. Complaints you can get at CLL:

• fatigue;
• excessive perspiration at night (night sweats);
• weight loss;
• increased bleeding tendency;
• enlarged lymph nodes;
• enlarged spleen and liver;
• increased risk of infections.

Risk factors for CLL

Not much is known about the risk factors for CLL. There seems to be no connection with smoking, drinking or other unhealthy habits. Whether there are hereditary causes is also unclear. Sometimes CLL occurs more often in certain families and suggests that heredity may play a role. But there is no certainty about that for a long time. Further research is being done on this. In any case, CLL is not directly transferred from parents to children.

Treatment indications

As mentioned earlier, an advanced stage of the disease is a reason to start treatment at Sheba Medical Cancer Center. At a less advanced stage, there is reason to start if there is at least one characteristic of an ‘active disease’. These characteristics are:

• disease-related symptoms (more than 10 percent weight loss in the last six months, extreme fatigue, more than two weeks of fever over 38.6 ° C without infections, night sweats without infections);
• development or worsening of anemia or platelet deficiency;
• breakdown of red blood cells or platelets that do not respond well to treatment with medicines (steroids);
• a strongly enlarged spleen or a spleen that quickly grows larger;
• heavily set up lymph nodes or glands that grow rapidly;
• an increase in the number of malignant lymphocytes by more than fifty percent within two months, or a doubling of the number in less than six months.