Chronic lymphocytic leukemia is a malignancy that affects the B-lymphocyte lineage and is characterized by the production of large numbers of immature lymphocytes that accumulate in the bone marrow and inhibit its normal hematopoiesis; and the ability to spread throughout the body through the bloodstream, causing the patient to develop anemia, easy bleeding, infection and organ infiltration. Chronic lymphocytic leukemia is a slowly progressive, inert tumor in which patients usually remain asymptomatic for months to years.
Chronic lymphocytic leukemia is a relatively uncommon malignancy, accounting for approximately 0.8% of all cancers.
Who can have this disease?
Chronic lymphocytic leukemia can occur in people of any age, but it is most common in people over 60 years of age and is more common in men than women.
What causes it?
The cause of chronic lymphocytic leukemia is still unknown.
What are its symptoms?
Because chronic lymphocytic leukemia progresses slowly, many patients are asymptomatic, especially in the early stages. As the disease progresses, the leukemia destroys the normal hematopoietic function of the bone marrow and infiltrates organs, causing obvious but non-specific symptoms. Included are.
1. anemia, manifested as weakness, dizziness, pallor or shortness of breath after activity
2. recurrent infections and not easily cured, mainly due to the lack of normal white blood cells, especially neutrophils.
3. bleeding tendency: easy bleeding, bleeding more than once, gum bleeding, stool bleeding and irregular menstrual bleeding, due to thrombocytopenia
4. enlargement of superficial lymph nodes, unexplained wasting and night sweats, etc.
How is this disease diagnosed?
Acute lymphocytic leukemia is diagnosed mainly by blood tests and bone marrow aspiration biopsy; it is manifested by abnormally high peripheral blood leukocytes and a large accumulation of leukemic cells in the bone marrow. According to the International Working Group on Chronic Lymphocytic Leukemia, the diagnostic criteria are: peripheral blood lymphocytes ≥ 10×109/L, bone marrow lymphocyte ratio ≥ 30% or the presence of lymphocytes with a monoclonal immunophenotype.
How is it treated?
Chronic lymphocytic leukemia is an inert tumor of the lymphatic system that can remain asymptomatic for months to years without requiring treatment. However, treatment is required for certain conditions such as the onset of symptoms.
1. The presence of any of the following symptoms associated with the disease.
(1) Weight loss ≥10% within six months
(2) Significant weakness (e.g., inability to perform normal work or activities of daily living)
(3) Excluding the cause of infection, temperature > 38 degrees and persist for more than 2 weeks
(4) Exclusion of infectious factors, the presence of night sweats
2. Presence of failure of normal hematopoietic function of bone marrow, such as decreased red blood cells and platelets
3. Autoimmune anemia or thrombocytopenia with insensitivity to hormone therapy
4. Severe or progressive splenomegaly
5. Large lymph nodes (e.g., masses longer than 10 cm in length) or progressive lymph node enlargement
6. Progressive lymphocytosis with an increase of more than 50% within two months; or lymphocyte multiplication time of less than 6 months
The treatment plan is mainly single agent or combination chemotherapy, depending on the severity of the patient’s symptoms and the degree of tolerance to chemotherapy.
What are the side effects of treatment?
Treatment relapse varies according to the type and severity of the patient, depending on the treatment regimen received and individual factors. In general, the stronger the treatment regimen, the more severe the associated side effects. Most side effects are manageable and reversible.
Chemotherapy mainly causes myelosuppression, often within a week of chemotherapy, and recovery takes time, depending on the type and dose of chemotherapy drugs and the patient’s response to leukemia treatment. During this time, patients usually require adequate supportive care, such as isolation in a laminar bed, leukocyte-raising therapy, antibiotic therapy, and blood transfusions.
Other complications of chemotherapy are.
1.Fatigue and weakness
2. Loss of appetite, nausea and vomiting
3.Mouth ulcers
4.Diarrhea or constipation
5.Infertility
6.Could cause second tumor