--- title: Chronic Lymphocytic Leukemia (CLL) url: "https://www.yyhmedical.com/en/guide/blood/chronic-lymphocytic-leukemia" type: MedicalWebPage inLanguage: en-US --- # Chronic Lymphocytic Leukemia (CLL) > Chronic lymphocytic leukemia (CLL) is a type of blood cancer that usually progresses slowly and is most common in older adults. Some people with CLL may not need treatment right away and can be monitored through regular follow-up. ## Overview Chronic lymphocytic leukemia (CLL) is a type of blood cancer in which abnormal B lymphocytes gradually build up in the blood, bone marrow, lymph nodes, and spleen. CLL usually progresses slowly. Some people have no symptoms when they are diagnosed, and the disease may be found during a routine blood test. As CLL progresses, symptoms may include swollen lymph nodes, an enlarged liver or spleen, fatigue, fever, night sweats, unexplained weight loss, or frequent infections. A diagnosis of CLL does not always mean treatment needs to start right away. People without symptoms or other indications for treatment may be monitored regularly. Treatment can be started if the disease progresses or other reasons for treatment develop. ## Causes and Risk Factors The exact cause of CLL is not known. It develops when genetic changes cause certain B lymphocytes to grow and survive longer than they normally would. Over time, these abnormal cells can build up in the body. Several factors are associated with a higher risk of CLL: - **Age:** CLL is most commonly diagnosed in older adults. - **Family history:** Having a close relative with CLL or another blood cancer may increase the risk. - **Sex:** CLL is more common in men than in women. - **Certain environmental or occupational exposures:** Some exposures may be associated with an increased risk of CLL, although their role is still being studied. Having one or more risk factors does not mean that someone will develop CLL, and many people diagnosed with CLL have no known risk factors. ## Signs and Symptoms Many people with CLL have no symptoms in the early stages. When symptoms do occur, they may include: - Ongoing fatigue or weakness - Fever - Night sweats - Unexplained weight loss - Swollen lymph nodes in the neck, armpits, or groin - An enlarged liver or spleen - Frequent or persistent infections - Easy bruising or bleeding - Shortness of breath - Feeling full after eating only a small amount These symptoms can also be caused by other conditions. Tests are needed to determine whether they are related to CLL. ## Diagnosis If blood tests show a persistently high lymphocyte count or there are other signs that suggest CLL, additional testing may be needed. ### **Blood Tests** A complete blood count (CBC) measures the number of different types of blood cells. People with CLL typically have an increased number of lymphocytes in the blood. Some may also have anemia or a low platelet count. ###  **Flow Cytometry and Immunophenotyping** Flow cytometry and immunophenotyping examine specific markers on the surface of lymphocytes. These tests can help determine whether abnormal lymphocytes are CLL cells and distinguish CLL from other blood disorders. ### **Bone Marrow Tests** A bone marrow aspiration and/or biopsy may be performed in some cases to evaluate CLL cells in the bone marrow.However, bone marrow testing is not always required to diagnose CLL. Whether it is needed depends on the individual situation. ### **Genetic and Molecular Testing** Genetic, chromosomal, and molecular testing can provide more information about the biological features of CLL.For example, **del(17p), TP53 abnormalities, and IGHV mutation status** can help assess risk and guide treatment decisions. ## Treatment Treatment for CLL depends on whether there are indications for treatment, as well as the characteristics of the disease, genetic and molecular features, age, overall health, and previous treatments. **Not everyone with CLL needs treatment right away.** ### **Active Surveillance (Watch and Wait)** For people with early-stage CLL who have no symptoms or other indications for treatment, regular monitoring may be recommended instead of starting treatment immediately. This approach is often called **active surveillance** or **watch and wait**. Follow-up usually includes regular blood tests and physical exams to monitor for changes in the disease. Watch and wait does not mean ignoring the disease. It means monitoring CLL closely and starting treatment when it becomes necessary. ### ### **Targeted Therapy** Targeted therapy is an important part of CLL treatment today. These medications act on specific pathways that CLL cells use to grow and survive. Common targeted therapies include **BTK inhibitors and BCL-2 inhibitors**. Treatment choices depend on the characteristics of the CLL, genetic and molecular test results, overall health, and previous treatments. ### **Immunotherapy** Some treatments use antibodies that recognize specific proteins on CLL cells and help the immune system target them. For example, **anti-CD20 monoclonal antibodies** may be used alone or in combination with other treatments. ### **Chemotherapy and Chemoimmunotherapy** Chemotherapy and chemoimmunotherapy were once major treatments for CLL. With the development of targeted therapies, treatment options have changed significantly. Chemotherapy or chemoimmunotherapy may still be considered in selected situations. ### **Radiation Therapy** Radiation therapy is not commonly used as a primary treatment for CLL. In selected cases, localized radiation may be used to relieve symptoms caused by enlarged lymph nodes or an enlarged spleen. ###  **Hematopoietic Stem Cell Transplantation (HSCT)** Hematopoietic stem cell transplantation (HSCT) is not a routine treatment for most people with CLL. An **allogeneic hematopoietic stem cell transplant** may be considered for a small number of people with high-risk or difficult-to-treat CLL when other treatments have not provided adequate disease control. Whether transplantation is appropriate depends on factors such as disease risk, response to previous treatment, age, overall health, and donor availability. ## Content attribution (YMYL) - Author: - Medically reviewed by: - Last reviewed: - First published: - Sources: - National Cancer Institute (NCI). Chronic Lymphocytic Leukemia Treatment (PDQ®)–Patient Version. (https://www.cancer.gov/types/leukemia/patient/cll-treatment-pdq) - National Cancer Institute (NCI). Chronic Lymphocytic Leukemia Treatment (PDQ®)–Health Professional Version. (https://www.cancer.gov/types/leukemia/hp/cll-treatment-pdq) - American Cancer Society (ACS). Tests for Chronic Lymphocytic Leukemia (CLL). (https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/detection-diagnosis-staging/how-diagnosed.html) - American Cancer Society (ACS). Treating Chronic Lymphocytic Leukemia (CLL). (https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/treating.html) > --- Original (HTML):https://www.yyhmedical.com/en/guide/blood/chronic-lymphocytic-leukemia This is a clean Markdown mirror for large language models; the original page is authoritative.