Chronic lymphocytic leukemia – KhLL

Description of chronic lymphocytic leukemia

Chronic lymphocytic leukemia (KhLL) – рак крови и костного мозга. Лимфоциты – тип белых кровяных клеток. In CLL, the bone marrow produces too many of them. CLL begins in mature lymphocytes and gradually progresses. The disease may develop slowly over many years and not cause any health problems.. But CLL can also eventually develop into a more aggressive form of leukemia, Acute leukemia lymfoblastnыy (OLL). Some forms of CLL can be dangerous, because leukemia affects the immune system.

Cancer occurs, when the body's cells start to uncontrollably shares. Лейкемия – рак белых кровяных клеток и их клеток-родителей. In leukemia, the white blood cells, lymphocytes, unable to fight off infections and the person is more likely to become infected with viruses or bacteria. Cancer cells also develop in the bone marrow and affect normal blood components, such as platelets, which are necessary for blood clotting.

CLL may also be associated with the presence of chronic lymphocytic lymphoma. Это один из видов неходжкинской лимфомы. Abnormal cells in both cases can be produced from the same parent cells. As a result,, One of the signs of CLL may be a tumor in the lymph nodes.

Causes of chronic lymphocytic leukemia

The exact cause of CLL is unknown. Expected, that changes in chromosomes may be associated with CLL, that occur during life. CLL is also associated with exposure to radiation and toxic chemicals, such as:

• Benzene (used in agriculture, production of paints and dyes);
• Agent Orange (gerbicidы, used during the Vietnam War).

Risk factors for chronic lymphocytic leukemia

Factors, which increase the likelihood of developing CLL:

• Age: middle and old;
• Paul: male;
• Family history of CLL or lymphatic system cancer;
• Presence of Russian Jews or Eastern European Jews among relatives;
• Exposure to Agent Orange.

Symptoms of chronic lymphocytic leukemia

Symptoms include:

• Painless swelling in the neck, armpits, in the abdomen or groin area;
• Fatigue;
• Paleness (signs of anemia);
• Pain or feeling of fullness below the ribs;
• Fever;
• Infection;
• Unexplained weight loss;
• The decrease in exercise tolerance;
• Pain in the bones;
• Enlarged liver and spleen.

Diagnosis of chronic lymphocytic leukemia

The doctor will ask about your symptoms and medical history, and perform a physical examination. Your doctor may also check for swelling of the liver, spleen or lymph nodes in the armpits, in the groin or neck. Вы можете быть направлены в онкологу – врачу, who specializes in treating cancer.

Tests may include:

• Анализы крови – для проверки изменений в количестве или появлении различных типов клеток крови;
• Аспирация костного мозга – удаление образца жидкости костного мозга для проверки на наличие раковых клеток;
• Биопсия костного мозга – удаление образца жидкости костного мозга и небольшого образца кости для проверки на наличие раковых клеток;
• Спинномозговая пункция – удаление небольшого количества спинномозговой жидкости, to check for cancer cells;
• Осмотр образцов под микроскопом – исследование образцов крови, bone marrow fluid, lymph node tissue, or cerebrospinal fluid;
• Analyses of bones, blood, bone marrow, ткани лимфатического узла или спинномозговой жидкости – чтобы классифицировать тип лейкемии и определить, whether leukemic cells in the lymph nodes or cerebrospinal fluid;
• Цитогенетический анализ – тест, allowing to find certain changes in the chromosomes (genetic material) lymphocytes. Used, to establish a specific diagnosis and develop a treatment plan for CLL;
• Рентген грудной клетки – позволяет обнаружить признаки инфекции легких или рак груди;
• Компьютерная томография брюшной полости – вид рентгена, which uses computer, to make pictures of organs inside the body;
• МРТ – тест, which uses magnetic waves, to make pictures of structures inside the body;
• Галлиевое сканирование и сканирование костей – инъекция радиоактивного химического вещества в кровь для выявления областей распространения рака или инфекции;
• УЗИ – обследование, which uses sound waves to study the internal organs.

Treatment of chronic lymphocytic leukemia

The treatment method depends on the stage of the disease and the patient's health.

Vыzhidatelynaya tactics

The doctor monitors the progress of the disease. Treatment does not begin until symptoms and possible problems appear, associated with CLL. Other problems, including infections, can be treated in the usual way. Watchful waiting is often used when the risk of complications from CLL is low. Some patients do not require invasive treatment for CLL for many years.

Radiation therapy for chronic lymphocytic leukemia

Radiation is used, to kill cancer cells and shrink tumors. Для лечения ХЛЛ используется внешняя лучевая терапия, in which radiation is directed to the tumor from a source, which is outside the body. This procedure is used to treat the brain and spinal cord when indicated. Radiation therapy is also used to treat problem lymph nodes.

Chemotherapy for chronic lymphocytic leukemia

Химиотерапия – использование лекарственных препаратов для уничтожения раковых клеток. Preparations for the chemotherapy may be given in various forms: tablets, injection, the introduction of a catheter. The drugs enter the bloodstream and spread throughout the body, killing mostly cancer, and also some healthy cells.

Surgery for chronic lymphocytic leukemia

Может быть проведена спленэктомия – операция по удалению селезенки.

Treatment with monoclonal antibodies

Antibodies are used in treatment, produced in the laboratory. Antibodies help identify substances in cancerous or normal cells, which lead to the development of cancer. Antibodies then attach to these substances, what kills cancer cells, blocks their growth or prevents their spread.

Chemotherapy with stem cell transplant

Химиотерапия с трансплантацией стволовых клеток для лечения ХЛЛ все еще проходит клинические испытания. Chemotherapy followed by stem cell transplantation (immature blood cells). They will replace blood-forming cells, destroyed by cancer treatment. Stem cells are selected from blood or bone marrow donor, then administered to the patient.

Treatment of side effects

Patients suffer from side effects not only with leukemia, but from therapy. Complications include:

• Reduction in the number of red blood cells, which can lead to anemia;
• Decreased platelet count, which are involved in the blood clotting process (thrombocytopenia);
• Decreased white blood cell count, that fight infections.

Anemia can lead to fatigue, and in serious cases, complicate diseases of the respiratory or cardiac system. Thrombocytopenia can lead to bleeding and bruising. A decrease in white blood cell counts may make a patient more vulnerable to infections.

Medicines are prescribed to increase the production of normal blood cells. In some cases, the doctor may recommend a blood transfusion. You may also need to reduce your physical activity, to reduce fatigue, chance of bleeding or infection.

Prevention of chronic lymphocytic leukemia

Since the cause of CLL is unknown, there are no guidelines to prevent it.