Chronic lymphocytic leukaemia (CLL) is a blood cancer characterised by the overproduction of B lymphocytes. B lymphocytes protect the body against germs by producing proteins called antibodies.
In CLL, abnormal B lymphocytes progressively infiltrate the bone marrow, lymphatic tissues (mainly the lymph nodes and spleen) and other organs such as the liver. The clinical manifestations of the disease are a consequence of this infiltration, which displaces normal blood elements and impedes the proper functioning of the affected organs. In addition, the lymphocytes that are produced do not function properly and cannot fulfil their function of defending the body.
CLL usually affects people over 60 years of age and progresses very slowly.
The main symptoms may include weakness, lymphadenopathy (enlarged lymph nodes) and repeated infections. Splenomegaly (swelling of the spleen) or hepatomegaly (enlargement of the liver) is not unusual, and may cause abdominal discomfort. Unlike in lymphomas, fever, night sweats and weight loss are uncommon (10%).
In more than 80% of patients, CLL is diagnosed either by a routine blood test or by chance, as they are usually completely asymptomatic.
A blood test is sufficient for establishing a CLL diagnosis.
The prognosis of a patient with CLL is highly variable depending on the presence or absence of a number of prognostic factors such as: the stage of the disease, the doubling time of the lymphocyte count, the presence of certain cytogenetic alterations, and the increase in certain serum markers.
Approximately 5% to 10% of patients with CLL progress to an aggressive variety of lymphoma, called Richter's Syndrome, which requires intensive chemotherapy treatment.
Between 5% and 10% of patients with CLL progress to an aggressive form of lymphoma, called Richter’s syndrome, which requires intensive chemotherapy.
Patients with early stage CLL usually do not require treatment for years, and can lead a normal life. Criteria for initiating treatment are the presence of: very obvious systemic symptoms (fever, sweating, weight loss), large lymphadenopathy or splenomegaly causing discomfort, recurrent infections, progressive increase in anaemia and/or progressive decrease in platelet count, and very rapid lymphocyte doubling time (less than 12 months). A very high lymphocyte count alone is not a criterion for initiating treatment.
These patients should be treated with one of the multiple chemotherapy regimens currently in use. None of these treatments can cure CLL, although the responses achieved may be sustained for many years.
Unlike other leukaemias, CLL is not usually treated with haematopoietic stem cell transplantation due to the advanced age of most patients. However, young patients with aggressive CLL may benefit from this therapeutic measure if they have a compatible donor, as this is the only therapy that can cure the disease.
The haematology unit offers comprehensive care for patients with haematological malignancies
The Service's team of professionals accompanies cancer patients throughout the whole disease process.
A clinical trial is a research study carried out on people with the aim of learning more about how the body reacts to certain treatments. These trials generally seek to find drugs that are more effective than the current best therapeutic option for patients, or that have similar efficacy but a better toxicity profile.
Bearing in mind that almost all currently available treatments are the result of clinical research, the importance of clinical trials is obvious.
The IVO has a clinical trials unit for all types of tumours and participates in phase 1-3 studies as well as other types of studies.
Whether you receive the news of an initial diagnosis of cancer or a relapse, coping with cancer can be emotionally overwhelming. Each person has their own way of coping with a leukemia diagnosis, but there are some recommendations that can help you through this process: