Chronic lymphocytic leukemia (CLL) is a cancer characterized by the excess production of lymphocytes by the bone marrow. Almost all patients of CLL have no symptoms even after diagnosis because the growth of CLL is slow. Many times, the leukemia is determined when the patients take regular blood tests for other distinct health problems or as part of any other normal checkup.
Then, the doctors identify the growth of a large number of lymphocytes. Some people with CLL might have symptoms that are mostly ambiguous or are a symptom of another disease.
The common symptoms of CLL are mentioned below:
- Fatigue: It can be described as the loss of energy both mentally and physically. This can widely reduce the frequency of regular activity. Fatigue is different from drowsiness.
- Enlargement of lymph nodes: if a person is affected with CLL, the lymph nodes at certain places of the body get enlarged. It occurs beneath the skin, which seem like lumps. Lymph nodes (glands) swell in the neck, beneath the skin, or in the groin (placed between the stomach and upper thigh). Generally, enlargement of lymph nodes—which means group of lymphocytes are stored in one place—do not produce pain.
- Feeling fullness in the stomach: This means that a person senses fullness in the abdomen even after taking a small meal. This sensation arises due to the enlargement of the liver or the spleen. It may also cause swelling in the stomach, which is accompanied by pain beneath the left-hand side ribs. On the whole, this results in a lack of desire to eat.
- B-symptoms: These are the commonly occurring symptoms that include
- night sweats
- Weight loss due to loss of appetite and use of high amount of energy. This weight loss may not be intentional.
Symptoms of Advanced CLL
A lot of symptoms and marks of advanced CLL appear due to the leukemia cells that replace the bone marrow of the blood cells. That is why these people do not have abundant red blood cells, regularly functioning white blood cells, and platelets in the blood.
Signs of advanced CLL are as follows:
- Anemia— this occurs because of less number of red blood cells. By utilizing red blood cells, oxygen gets transferred all over the body. The lack of these cells may reduce the capacity of the blood to carry oxygen. Anemia is a main factor that causes shortness of breath, especially when the person is active physically. The CBC (complete blood count) test is used to detect the blood cell counts.
Symptoms related to anemia are:
- feeling of tiredness;
- paleness due to reduction in the red blood cell count;
- worsened heart problems.
- Leukopenia: Lack of healthy white blood cells.
When white blood cells (WBCs) are affected by lymphocytic leukemia, the body may produce a large number of abnormal WBCs (lymphocytosis). However, these excess leukemia cells cannot protect our body from disease and inflammation.
Thrombocytopenia: (lack of blood platelets). Platelets that are present in the blood help in blood clotting. Platelet counts are determined by utilizing the CBC test. The main symptom of thrombocytopenia is abnormal bleeding, which can be nose bleeding, bleeding of the gums, or excess bruising (injuring).
- Recurrent infection also happens due to the lower number of healthy WBCs, one of the symptoms of leukopenia. Though the lungs, kidney, skin, and other parts are affected indicating the low level of the immune system level, it also reduces the white blood cell count.
Symptoms that are related include:
- recurrent infections like cold;
- fever (high temperature (38˚C);
- reduced powers of immunity;
- sweating, etc.
CLL is a tumor of B cells (called B lymphocytes). These cells are specialized white blood cells. Generally, B cells produce antibodies that help to protect our bodies against disease and infections. In people with CLL, however, the immune system produces unhealthy or abnormal antibodies that do not work normally and hence reduce immunity. Such people also have a lot of recurrent ailments of fever, cold, and other infections.
In some other ways, CLL affects the immunoglobulins. For people with CLL, unhealthy antibodies are created from the immune system. It affects the normal healthy cells. This is referred as autoimmunity. It shows a low number of normal white blood counts. When red blood cells are affected by abnormal antibodies, it is known as autoimmune hemolytic anemia. But antibodies frequently take less time to affect the platelets, so this also results in low platelet counts.
The above-mentioned are the main markers of CLL. As identification of the disease is difficult solely through the symptoms due to its misleading nature or lack of presence, the chances of complication are greater. Regular checkups can help in early diagnosis of the condition.
Reviewed by Afsaneh Khetrapal BSc (Hons)