Chronic Lymphocytic Leukaemia

What is Chronic Lymphocytic Leukemia?

Chronic lymphocyticleukemia (CLL) is one kind of blood cancer which targets the B lymphocytes which are a type of white blood cells that are essential to immunity. In CLL the bone marrow produces abnormal lymphocytes that do not develop and function properly. The dysfunctional cells grow slowly, but gradually, and crowd out healthy blood cells with time.

In contrast to acute leukemia CLL develops slowly and a lot of people are affected for many years, without the need for immediate treatment. In some instances treatment is required to stop the progression of the disease.

How CLL Develops

CLL begins in CLL originates in the bone marrow in which all blood cells are created by stem cells. Normally, B cells that are immature (lymphoblasts) transform to become functional lymphocytes. In CLL the process of maturation is disturbed. The immature cells multiply uncontrollably but do not fully mature, harming the immune system, result in a build-up of the lymph nodes, blood the bone marrow, and lymph nodes.

This can affect the creation of:

• The red blood cell (causing anemia),

• White blood cell health (leading to the development of infections),

• Platelets (resulting in bleeding and bruising issues).

How Common is CLL?

CLL happens to be the most commonly diagnosed form of leukemia among adulthood in India especially in those who are older than 70. It is estimated that 70 000 newly diagnosed cases are reported each year and many suffer with the disease for long periods of time because of its slow progress.

Symptoms of CLL

CLL is not usually a cause of symptoms at the beginning of the disease and could be identified through normal blood tests. As the progression of the disease, symptoms could include:

• Swollen lymph nodes (neck, armpits, groin)

• Persistent fatigue

• Infections that are frequent

• Unintentional weight loss

• Night sweats

• Simple bleeding or bruising

• Breathing shortness

• The feeling of being full after eating a small meal (due to an increased stomach)

Diagnosis

CLL is often diagnosed by:

• Comprehensive blood count (CBC): Reveals the presence of lymphocytes in high levels

• Flow Cytometry Identifies particular marks on B cells

• Bone Marrow Biopsy (if required): Assesses marrow involvement

• Genetic testing: Helps in risk stratification and treatment strategy

Chronic Lymphocytic Leukemia Treatment

Treatment for CLL is dependent depending on degree of illness, overall health and the speed at which the cancer is growing. In many instances the “watch and wait” method is used in cases of mild symptoms and blood count is stable.

Active Treatments Include:

1. Targeted Therapy:

• These medications target B cells that are cancerous specifically.

• Common agents are Ibrutinib, acalabrutinib along with venetoclax.

2. Immunotherapy:

• Monoclonal antibodies like the rituximab aid the immune system to recognize and eliminate cancerous cells.

3. Chemotherapy:

• It is used less often now because of the efficacy of targeted treatments.

• Treatments such as fludarabine, cyclophosphamide and bendamustine can be used in conjunction with immunotherapy.

4. Stem Cell Transplant (Rarely Required ):

• The treatment is often considered for CLL with high risk or in cases which do not respond to other treatment options.

• The majority of transplants can be allogeneic made using donor stem cells.

• Transplants that are autologous (using your stem cells from your own) are not often done.

Living with CLL

CLL can be managed for a lengthy period of time. A regular check-up with a hematologist is crucial. Lifestyle changes, like staying clear of infections, eating a healthy diet, and identifying any new signs early are crucial to living a healthy life with CLL.

Self-Care & Monitoring

• Follow your schedule for monitoring (CBC imaging physical exams)

• If you notice any new or more severe symptoms, report it immediately.

• Avoid prescription medications that can affect the treatment

• Keep up-to-date with vaccinations (after consulting with your physician)

Prognosis and Long-Term Outlook

With the advancements in CLL treatment Patients can now enjoy full, active lives. While it’s not always curable in many instances, CLL often behaves more as a chronic illness rather than a cancer that is aggressive, especially when it comes to modern treatments.