Chronic lymphocytic leukemia – KhLL

Description of chronic lymphocytic leukemia

Chronic lymphocytic leukemia (KhLL) – cancer of the blood and bone marrow. Lymphocytes – a type of white blood cells. 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. Leukemia – cancer of the white blood cells and their parent cells. 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. This is one of the types non-Hodgkin's lymphoma. 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. You may be directed to the oncologist – doctor, who specializes in treating cancer.

Tests may include:

• Blood tests – to check for changes in the quantity or appearance of various types of blood cells;
• Bone marrow aspiration – removal of a sample of liquid bone marrow to test for cancer cells;
• Bone marrow biopsy – removing the fluid sample of bone marrow and a small sample of bone to test for the presence of cancer cells;
• Spinnomozgovaya puncture – removal of a small amount of cerebrospinal fluid, to check for cancer cells;
• Examination of the samples under a microscope – the study of blood samples, bone marrow fluid, lymph node tissue, or cerebrospinal fluid;
• Analyses of bones, blood, bone marrow, lymph node tissue, or cerebrospinal fluid – to classify and determine the type of leukemia, whether leukemic cells in the lymph nodes or cerebrospinal fluid;
• Cytogenetic analysis – test, allowing to find certain changes in the chromosomes (genetic material) lymphocytes. Used, to establish a specific diagnosis and develop a treatment plan for CLL;
• Chest X-ray – It can detect signs of lung infection or cancer of the breast;
• Computed tomography of the abdomen – X-ray views, which uses computer, to make pictures of organs inside the body;
• MRT – test, which uses magnetic waves, to make pictures of structures inside the body;
• Gallium and bone scans – injection of a radioactive chemical into the blood to identify areas of cancer or infection;
• US – examination, 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. Used to treat CLL External radiation therapy, 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

Chemotherapy – the use of drugs to kill cancer cells. 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

It may be carried out splenectomy – surgery to remove the spleen.

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

Chemotherapy stem cell transplantation still undergoing clinical trials for the treatment of CLL. 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.