Table of ContentsView AllTable of ContentsAcute vs. ChronicSymptomsComplicationsTreatment SuccessDelaying TreatmentTreatment PlanRemissionSelf-CareSupportNext in Chronic Lymphocytic Leukemia GuideSymptoms of Chronic Lymphocytic Leukemia
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Table of Contents
Acute vs. Chronic
Symptoms
Complications
Treatment Success
Delaying Treatment
Treatment Plan
Remission
Self-Care
Support
Next in Chronic Lymphocytic Leukemia Guide
Chroniclymphocytic leukemia(CLL) is a bone marrow cancer leading to abnormal white blood cells in the blood. It’s slow-growing and mainly affects older adults. It can be years before chronic lymphocytic leukemia needs treatment, and treatments can keep the worst symptoms at bay for many years.
In this case, “chronic” means the cancerous cells are partially mature. The cancer cells look normal but don’t work as well and live longer than healthy cells. This cancer takes time to show symptoms.
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CLL is slow growing but very hard to cure.As the disease progresses, the defective cells grow and spread to thelymph nodes,liver, andspleen. Abone marrow transplantis the only cure but is not often the best treatment choice. Many people live with this cancer until they die of other causes.
This article will explain chronic lymphocytic leukemia, the symptoms and treatments, and what people can expect regarding life expectancy, survival, remission, and relapse rates. It will also advise on living with this slow-growing cancer with lifestyle, medical treatments, and ways to improve quality of life.
Acute vs. Chronic Lymphocytic Leukemia
Chronic lymphocytic leukemia is just one of many types of leukemias (cancers of the white blood cells). Specifically, CLL differs fromacute lymphoblastic leukemiabecause of how mature the cancer cells are.
Leukemia TypesLeukemias are classified as myeloid or lymphocytic depending on what precursor cells the cancer starts in. Lymphocytic, lymphoid, or lymphoblastic leukemias start in the cells that becomelymphocyte white blood cells.Myeloidleukemias begin in the bone marrow cells that become other types of white blood cells, red blood cells, andplatelets.
Leukemia Types
Leukemias are classified as myeloid or lymphocytic depending on what precursor cells the cancer starts in. Lymphocytic, lymphoid, or lymphoblastic leukemias start in the cells that becomelymphocyte white blood cells.Myeloidleukemias begin in the bone marrow cells that become other types of white blood cells, red blood cells, andplatelets.
Chronic leukemia cells mature partly and look more like normal white blood cells than other leukemia cells. Acute leukemias have cancer cells that look more immature, wild, and defective. Chronic leukemias are slow growing but are more complicated to cure than acute leukemias.
CLL often affects older adults. It’s rare in children but is the most common leukemia in adults—accounting for about 38% of new leukemia cases in adults.Estimates for 2023 suggest 18,740 new cases and 4,490 deaths from CLL.It is more common in men than women.The terms for sex or gender from the cited source are used.
Major Differences Between Leukemia and Lymphoma
Symptoms: Do I Have Chronic Lymphocytic Leukemia?
Most of the time, people diagnosed with chronic lymphocytic leukemia do not have symptoms. It’s often found based on blood tests done for other reasons.
The symptoms of chronic lymphocytic leukemia often are vague and are also symptoms of diseases other than cancer.Chronic lymphocytic leukemia symptomsinclude:
If you have these symptoms, abnormal blood tests, and are the right age for chronic lymphocytic leukemia, your healthcare provider will order tests todiagnose chronic lymphocytic leukemia.
Tests include:
Causes and Risk FactorsMost cases of chronic lymphocytic leukemia do not have a cause.Risk factorsinclude older age, exposure to chemicals (research has linked exposure to Agent Orange herbicide, other pesticides, and radon to chronic lymphocytic leukemia), family history of leukemias, and sex.
Causes and Risk Factors
Most cases of chronic lymphocytic leukemia do not have a cause.Risk factorsinclude older age, exposure to chemicals (research has linked exposure to Agent Orange herbicide, other pesticides, and radon to chronic lymphocytic leukemia), family history of leukemias, and sex.
Secondary Chronic Lymphocytic Leukemia Complications
Bone marrowin CLL makes new, abnormal lymphocytic white blood cells faster than usual. They live longer than they should and crowd out normal cells. As the body’s abnormal white blood cells build up, so do the signs and symptoms of advanced CLL.
Red blood cell and platelet counts drop, and normal white blood cells die off. This can cause several complications, including:
Many of these complications put people with CLL at a higher risk of infection. This might mean frequent colds, cold sore outbreaks, or a higher risk of developing illnesses likepneumonia(lung infection) or fungal infections.
The cancerous white blood cells in CLL may also make abnormal antibodies that attack normal blood cells—a complication known as autoimmunity. It may also causeautoimmune hemolytic anemia, in which the antibodies attack and destroy red blood cells.
As chronic lymphocytic leukemia advances, it can transform into more aggressive cancers that may be harder to treat, including:
Acute myeloid leukemiamay develop due to treatment that damages myeloid white blood cell precursors rather than CLL transforming into it.
How Successful Is Chronic Lymphocytic Leukemia Treatment?
Many people withCLL do not die of it. Only about one-third need treatment.Many are older (the average age at diagnosis is 70), and often, because the cancer is slow-growing, they may die from other causes before needing treatment. In one-third to one-half of cases, infections may kill the person before the cancer does.
If chronic lymphocytic leukemia advances and needs treatment, it can be tough to cure.But as new therapies are developed, many people can live years without their disease worsening.
Staging and Risk Groups
Healthcare providers determine the best treatment options and prognosis for people with chronic lymphocytic leukemia based on the stage of their disease. Staging is a way of comparing cancers, treatments, and predictions and is determined during diagnosis.
There are two different staging systems used for chronic lymphocytic leukemia. Doctors in the United States use the Rai system based on the number of lymphocytes in their blood and bone marrow.
The followingstages are used for chronic lymphocytic leukemia:
Doctors separate the five Rai stages into low-, intermediate-, and high-risk groups.
Other Factors in Prognosis
Other factors play a role in a person’s prognosis. Factors that negatively impact prognosis include:
Delaying Chronic Lymphocytic Leukemia Treatment
As chronic lymphocytic leukemia progresses, it has four stages, as follows:
People with slow-growing low-risk CLLwill not need treatment right away. Research has shown that treating this cancer early does not help people live longer. In the asymptomatic phase, healthcare providers will often wait on treatment and monitor the blood counts until the disease worsens or you start having bothersome symptoms.
Because people with chronic lymphocytic leukemia are usually older and CLL progresses slowly, one-third of people diagnosed with it will never need treatment.
About 88% of people over age 20 diagnosed with chronic lymphocytic leukemia are alive five years later.That doesn’t tell us much since many people with CLL will live years and years without even needing treatment.
Veterans With CLLBecause of the potential link between Agent Orange and leukemias, veterans with chronic lymphocytic leukemia exposed to Agent Orange or other herbicides during military service are eligible to receive health care and disability compensation from the Department of Veterans Affairs.
Veterans With CLL
Because of the potential link between Agent Orange and leukemias, veterans with chronic lymphocytic leukemia exposed to Agent Orange or other herbicides during military service are eligible to receive health care and disability compensation from the Department of Veterans Affairs.
After Diagnosis: Chronic Lymphocytic Leukemia Treatment Plan
Most people will wait on treatment until they have symptoms. When they need treatment, the first-line therapy for chronic lymphocytic leukemia has long been chemotherapy-immunotherapy. However, new targeted therapies have been developed. You may also need surgeries (likespleen removal) or radiation to reduce symptoms.
For many, treatment can prolong disease-free survival for many more years, even after they have symptoms and need treatment. New, targeted therapies called Brutontyrosine kinaseinhibitors significantly affect survival and quality of life.
Healthcare providers test new drugs and new drug combinations in clinical trials. Clinical trials should be a treatment option for anyone with chronic lymphocytic leukemia.
Researchers are still studying the impact of these targeted therapies on survival, but their impact seems significant. They can be used until they stop working, unlike chemotherapy, which is too toxic to be used for long periods. Studies have shown that:
In addition to new treatment options, there is a significant difference in survival based on the type and stage of chronic lymphocytic leukemia. CLL is classified into these two types:
Chronic Lymphocytic Leukemia Remission Statistics
For many, chronic lymphocytic leukemia treatment can be so effective that there are no signs of leukemia—known as complete remission. Though there is no cure, most people with CLL can undergo long periods of successful treatment without getting sicker.
But this disease often comes back at some point, so even if you’re in remission, it will not likely be a cure.Most people will relapse within the first five years of starting treatment. After first-line treatment with chemotherapy, 6% of cancers will return within 12 months, and another 14% will do so within two years.
Targeted therapies are more effective at prolonging progression-free survival than chemotherapy. Researchers are still studying the remission rates for these newer targeted therapies. How many people eventually relapse and require a new type of treatment is still unknown.
Self-Care With Chronic Lymphocytic Leukemia
Most people live with CLL for many years. About one-third will live out their lives and die from other causes without needing treatment. The rest will need treatment eventually, sometimes for years. Treatment, especially with chemotherapy, may stop for a while, but it never really ends.
What to Eat When You Have Chronic Lymphocytic Leukemia?
Support for Advanced Chronic Lymphocytic Leukemia
Many people with cancer feel depressed, anxious, or worried. Though chronic lymphocytic leukemia can take a long time to progress, it can be hard to live with the threat of cancer returning or getting worse hanging over your head.
You can benefit from leaning on friends, family, and community and finding support groups, professional counselors, or others to help you cope on your cancer journey.
Know that many new drugs have been developed for this disease; ask your healthcare provider about clinical trials. New therapies for CLL are helping people, even those with advanced disease, live longer, often with a higher quality of life than other treatments.
Many people with chronic lymphocytic leukemia stay on these treatments—sometimes without their disease worsening—until they die of other causes.
Studies have shown that about one-third to one-half of people with chronic lymphocytic leukemia die from infections.Your healthcare provider can take steps to help you fight off infections. These may include vaccines, medicines like antivirals, or other treatments.
Other people with chronic lymphocytic leukemia die from the effects of the cancer cells on different parts of the body, which stop these organs from functioning normally.
Advanced chronic lymphocytic leukemia is hard to cope with when drugs are no longer working. You’ll need to decide which treatments are suitable for you.
Palliative careaims at reducing symptoms of cancer and its treatment and helping you reach your goals—whether that’s staying active or staying at home.
Summary
Chronic lymphocytic leukemia is a type of blood cancer. It affects the bone marrow and causes an increase in abnormal lymphocytic white blood cells. It is most common in adults around age 70 and progresses slowly.
In CLL, the cancer cells occupy space and crowd out healthy cells. Symptoms of CLL can take a long time to appear. It’s often discovered during tests for other reasons. Healthcare providers use blood, bone marrow, and imaging tests to diagnose CLL.
Chemotherapy and immunotherapy used to be the treatment of choice for CLL. Now, targeted therapies are usually the best option.
Not all people need treatment immediately, especially if their CLL grows slowly and is low risk. Starting treatment early doesn’t always improve survival rates. Instead, healthcare providers suggest watchful waiting, which is when your provider monitors you before starting treatment.
How long someone with CLL will live depends on their age, health, genetics of their cancer, and the cancer’s stage. Many people with CLL don’t die from the disease itself.
Living with CLL involves managing symptoms and treatment side effects and improving quality of life. Complications include anemia, a higher risk of infections, and abnormal antibodies. Regular checkups and maintaining a healthy lifestyle are essential.
19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.What is chronic lymphocytic leukemia?American Cancer Society.Typical treatment of chronic lymphocytic leukemia.American Cancer Society.What Is chronic myeloid leukemia?American Society of Clinical Oncology.Leukemia - chronic lymphocytic - CLL: statistics.American Cancer Society.Key statistics for chronic lymphocytic leukemia.American Cancer Society.Signs and symptoms of chronic lymphocytic leukemia.American Cancer Society.If You Have Chronic Lymphocytic Leukemia (CLL)American Cancer Society.Do we know what causes chronic lymphocytic leukemia?American Cancer Society.Risk factors for chronic lymphocytic leukemia.Shadman M.Diagnosis and treatment of chronic lymphocytic leukemia: a review.JAMA. 2023;329(11):918-932. doi:10.1001/jama.2023.1946National Cancer Institute.Chronic lymphocytic leukemia treatment.American Cancer Society.Chronic lymphocytic leukemia stages.Department of Veterans Affairs.Chronic B-cell leukemias and Agent Orange - public health.American Cancer Society.What’s new in chronic lymphocytic leukemia research and treatment?American Cancer Society.Living as a chronic lymphocytic leukemia survivor.LeukemiaCare.Relapse in chronic lymphocytic leukaemia (CLL).Collins S.10 Years in CLL: top advances from 2012-2022.Targeted Therapies in Oncology. 2022;6:75-75.Crassini KR, Best OG, Mulligan SP.Immune failure, infection and survival in chronic lymphocytic leukemia.Haematologica. 2018;103(7):e329. doi:10.3324/haematol.2018.196543American Cancer Society.Supportive or Palliative Care for Chronic Lymphocytic Leukemia
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.What is chronic lymphocytic leukemia?American Cancer Society.Typical treatment of chronic lymphocytic leukemia.American Cancer Society.What Is chronic myeloid leukemia?American Society of Clinical Oncology.Leukemia - chronic lymphocytic - CLL: statistics.American Cancer Society.Key statistics for chronic lymphocytic leukemia.American Cancer Society.Signs and symptoms of chronic lymphocytic leukemia.American Cancer Society.If You Have Chronic Lymphocytic Leukemia (CLL)American Cancer Society.Do we know what causes chronic lymphocytic leukemia?American Cancer Society.Risk factors for chronic lymphocytic leukemia.Shadman M.Diagnosis and treatment of chronic lymphocytic leukemia: a review.JAMA. 2023;329(11):918-932. doi:10.1001/jama.2023.1946National Cancer Institute.Chronic lymphocytic leukemia treatment.American Cancer Society.Chronic lymphocytic leukemia stages.Department of Veterans Affairs.Chronic B-cell leukemias and Agent Orange - public health.American Cancer Society.What’s new in chronic lymphocytic leukemia research and treatment?American Cancer Society.Living as a chronic lymphocytic leukemia survivor.LeukemiaCare.Relapse in chronic lymphocytic leukaemia (CLL).Collins S.10 Years in CLL: top advances from 2012-2022.Targeted Therapies in Oncology. 2022;6:75-75.Crassini KR, Best OG, Mulligan SP.Immune failure, infection and survival in chronic lymphocytic leukemia.Haematologica. 2018;103(7):e329. doi:10.3324/haematol.2018.196543American Cancer Society.Supportive or Palliative Care for Chronic Lymphocytic Leukemia
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Cancer Society.What is chronic lymphocytic leukemia?American Cancer Society.Typical treatment of chronic lymphocytic leukemia.American Cancer Society.What Is chronic myeloid leukemia?American Society of Clinical Oncology.Leukemia - chronic lymphocytic - CLL: statistics.American Cancer Society.Key statistics for chronic lymphocytic leukemia.American Cancer Society.Signs and symptoms of chronic lymphocytic leukemia.American Cancer Society.If You Have Chronic Lymphocytic Leukemia (CLL)American Cancer Society.Do we know what causes chronic lymphocytic leukemia?American Cancer Society.Risk factors for chronic lymphocytic leukemia.Shadman M.Diagnosis and treatment of chronic lymphocytic leukemia: a review.JAMA. 2023;329(11):918-932. doi:10.1001/jama.2023.1946National Cancer Institute.Chronic lymphocytic leukemia treatment.American Cancer Society.Chronic lymphocytic leukemia stages.Department of Veterans Affairs.Chronic B-cell leukemias and Agent Orange - public health.American Cancer Society.What’s new in chronic lymphocytic leukemia research and treatment?American Cancer Society.Living as a chronic lymphocytic leukemia survivor.LeukemiaCare.Relapse in chronic lymphocytic leukaemia (CLL).Collins S.10 Years in CLL: top advances from 2012-2022.Targeted Therapies in Oncology. 2022;6:75-75.Crassini KR, Best OG, Mulligan SP.Immune failure, infection and survival in chronic lymphocytic leukemia.Haematologica. 2018;103(7):e329. doi:10.3324/haematol.2018.196543American Cancer Society.Supportive or Palliative Care for Chronic Lymphocytic Leukemia
American Cancer Society.What is chronic lymphocytic leukemia?
American Cancer Society.Typical treatment of chronic lymphocytic leukemia.
American Cancer Society.What Is chronic myeloid leukemia?
American Society of Clinical Oncology.Leukemia - chronic lymphocytic - CLL: statistics.
American Cancer Society.Key statistics for chronic lymphocytic leukemia.
American Cancer Society.Signs and symptoms of chronic lymphocytic leukemia.
American Cancer Society.If You Have Chronic Lymphocytic Leukemia (CLL)
American Cancer Society.Do we know what causes chronic lymphocytic leukemia?
American Cancer Society.Risk factors for chronic lymphocytic leukemia.
Shadman M.Diagnosis and treatment of chronic lymphocytic leukemia: a review.JAMA. 2023;329(11):918-932. doi:10.1001/jama.2023.1946
National Cancer Institute.Chronic lymphocytic leukemia treatment.
American Cancer Society.Chronic lymphocytic leukemia stages.
Department of Veterans Affairs.Chronic B-cell leukemias and Agent Orange - public health.
American Cancer Society.What’s new in chronic lymphocytic leukemia research and treatment?
American Cancer Society.Living as a chronic lymphocytic leukemia survivor.
LeukemiaCare.Relapse in chronic lymphocytic leukaemia (CLL).
Collins S.10 Years in CLL: top advances from 2012-2022.Targeted Therapies in Oncology. 2022;6:75-75.
Crassini KR, Best OG, Mulligan SP.Immune failure, infection and survival in chronic lymphocytic leukemia.Haematologica. 2018;103(7):e329. doi:10.3324/haematol.2018.196543
American Cancer Society.Supportive or Palliative Care for Chronic Lymphocytic Leukemia
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