LEUKEMIA, CHRONIC LYMPHOCYTIC

General Information

DEFINITION--A very slow-growing cancer of the blood-forming organs of older persons. About 1/3 of leukemia victims have this form. It is often discovered in a routine blood test for unrelated purposes.

BODY PARTS INVOLVED--Blood-forming organs: bone marrow; lymph glands; liver; spleen.

SEX OR AGE MOST AFFECTED--Both sexes, but more common in men over 50.

SIGNS & SYMPTOMS

In early stages, the following appear gradually:

• Fatigue and general weakness.
• Mild to moderate anemia.
• Firm, enlarged lymph nodes.
• Unexplained weight loss.
• Enlarged liver and spleen.
• Susceptibility to infection.
• Skin nodules (sometimes).

In late stages:

• Inability to resist bacterial, viral or fungal infections.
• Incapacitating weakness.

CAUSES--Unknown. Diagnostic tests show a proliferation of lymphocytes (a type of white blood cell). Unlike some forms of leukemia, excess exposure to radiation does not seem to be a factor in chronic lymphocytic leukemia.

RISK INCREASES WITH--Adults over 60.

HOW TO PREVENT--No specific preventive measures.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies of blood, bone marrow and cerebrospinal fluid; chest x-ray, CT scan, ultrasound (See Glossary for both) and spinal tap.
• The severity of the disease can be determined by the enlargement of the liver and spleen, anemia and the lack of platelet cells in the blood.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Sometimes, if it is a mild case, no treatment is needed.
• Treatment may include giving the patient anticancer drugs, followed by radiation therapy, and sometimes transfusions of blood and platelets.

POSSIBLE COMPLICATIONS

• Bleeding.
• Severe anemia.
• Infections.
• Gout.

PROBABLE OUTCOME--This condition is currently considered incurable. However, symptoms can be relieved or controlled. Many patients live for years with few or no symptoms, and medical literature cites a few instances of unexplained recovery. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

How To Treat

GENERAL MEASURES--

• Patient should avoid ill persons and crowds to prevent dangerous exposure to infection.
• Mouth care is important. Rinse the mouth often with a warm salt-water solution to decrease mouth ulcers. Use 1 tablespoon salt in 8 oz. water. Use a soft toothbrush to prevent gum abrasion.
• See Resources for Additional Information.

MEDICATION--Many persons with this disorder require little treatment. Treatment plans are highly individualized.

• Your doctor may prescribe: Anticancer medications, including cortisone drugs. Antigout drugs.
• Don't take aspirin or any product containing aspirin. Aspirin increases the likelihood of bleeding.

ACTIVITY--No restrictions.

DIET--No special diet. Eat as heartily as possible.

Call Your Doctor If

• You have symptoms of chronic lymphocytic leukemia.
• The following occurs after diagnosis and treatment: Recurrence or worsening of symptoms. Signs of infection, such as fever and chills. Black, tarry stools, bleeding gums or nosebleed.