Chronic lymphocytic leukemia | |
---|---|
Other names | B-cell chronic lymphocytic leukemia (B-CLL)[1] |
![]() | |
Peripheral blood smear showing CLL cells | |
Specialty | Hematology and oncology |
Symptoms | Early: None[2] Later: Non-painful lymph nodes swelling, feeling tired, fever, weight loss[2] |
Usual onset | Older than 50[3] |
Risk factors | Family history, Agent Orange, certain insecticides[2][4] |
Diagnostic method | Blood tests[5] |
Differential diagnosis | Mononucleosis, hairy cell leukemia, acute lymphocytic leukemia, persistent polyclonal B-cell lymphocytosis[5] |
Treatment | Watchful waiting, chemotherapy, immunotherapy[4][5] |
Prognosis | Five-year survival ~88% (US)[3] |
Frequency | 904,000 (2015)[6] |
Deaths | 60,700 (2015)[7] |
Chronic lymphocytic leukemia (CLL) is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).[2][8] Early on, there are typically no symptoms.[2] Later, non-painful lymph node swelling, feeling tired, fever, night sweats, or weight loss for no clear reason may occur.[2][9] Enlargement of the spleen and low red blood cells (anemia) may also occur.[2][4] It typically worsens gradually over years.[2]
Risk factors include having a family history of the disease, with 10% of those who develop CLL having such ancestry.[2][9] Exposure to Agent Orange, certain insecticides, sun exposure, exposure to hepatitis C virus, and common infections are also considered risk factors.[4][9] CLL results in the buildup of B cell lymphocytes in the bone marrow, lymph nodes, and blood.[4] These cells do not function well and crowd out healthy blood cells.[2] CLL is divided into two main types:
Diagnosis is typically based on blood tests finding high numbers of mature lymphocytes and smudge cells.[5]
Early-stage CLL in asymptomatic cases responds better to careful observation, as there is no evidence that early intervention treatment can alter the course of the disease.[10] Immune defects occur early in the course of CLL and these increase the risk of developing serious infection, which should be treated appropriately with antibiotics.[10] In those with significant symptoms, chemotherapy, immunotherapy, or chemoimmunotherapy may be used.[4] Depending on the individual's age, physical condition, and whether they have the del(17p) or TP53 mutation, different first line treatments may be offered.[11] As of 2021, BTK inhibitors such as ibrutinib and acalabrutinib are often recommended for first line treatment of CLL.[12] The medications fludarabine, cyclophosphamide, and rituximab were previously the initial treatment in those who are otherwise healthy.[13]
CLL affected about 904,000 people globally in 2015 and resulted in 60,700 deaths.[6][7] In 2021, the estimated incidence of CLL in the United States is 21,250 new cases and 4,320 deaths.[14] The disease most commonly occurs in people over the age of 65, due to the accumulation of genetic mutations that occur over time.[3][15] Men are diagnosed around twice as often as women (6.8 to 3.5 ratio).[16] It is much less common in people from Asia.[4] Five-year survival following diagnosis is approximately 83% in the United States.[3] It represents less than 1% of deaths from cancer.[7]
Hall2018
was invoked but never defined (see the help page).© MMXXIII Rich X Search. We shall prevail. All rights reserved. Rich X Search