Chronic Lymphocytic Leukemia is a type of blood and bone marrow cancer and is the most common type of leukemic in adults. Before we delve further into the causes, symptoms and diagnosis process of Chronic Lymphocytic Leukemia, let us first learn more about Leukemia.
What is Leukemia?
Leukemia is blood and bone marrow cancer and occurs when abnormal white blood cells are produced rapidly in the bone marrow. White blood cells help the body fight infection and are considered immunity cells. These abnormal leukemia cells are able to survive longer than normal white blood cells. Over time, the atypical white blood cells divide themselves to make more cells which will eventually crowd out the red blood cells and platelets that your body requires in order to maintain its normal function. Eventually, your body will not have sufficient platelets to clot blood and red blood cells to supply oxygen to body tissues. Additionally, there will also be a deficiency of healthy, fully developed white blood cells to fight infection.
What is Chronic Lymphocytic Leukemia (Chronic Lymphocytic Leukemia)?
“Chronic” refers to the prolonged progress of this type of Leukemia and the fact that it typically takes some time before Chronic Lymphocytic Leukemia causes problems.
The term “lymphocytic” refers to the white blood cell group that is affected by this type of Leukemia, lymphocytes, which are crucial in helping the body fight infection.
In cases of Chronic Lymphocytic Leukemia, the onset of the cancer is slow and gradual, with patients reporting symptoms of it only after a few years.
While the cause of Chronic Lymphocytic Leukemia is not yet known, doctors and scientists are certain that there is something that happens in cases of Chronic Lymphocytic Leukemia which leads to a genetic mutation in the chromosomes of cells that produce blood. As a result of this mutation, what was supposed to be a healthy white blood cell becomes a Leukemia cell that multiplies itself to create many more unhealthy cells. This eventually leads to a decreased number of not only healthy white blood cells but also red blood cells and platelets.
As the exact cause of Chronic Lymphocytic Leukemia is unknown, the risk factors linked to it are not definite either. However, based on the information that can be ascertained from patients of Chronic Lymphocytic Leukemia, we know that the following factors may lead to Chronic Lymphocytic Leukemia:
Gender – Chronic Lymphocytic Leukemia is more commonly diagnosed in men than in women.
Age – older adults are at a higher risk and about 90% of patients with Chronic Lymphocytic Leukemia are over 50 years of age.
Race – most Chronic Lymphocytic Leukemia patients are of European descent and this disease is less common among people of Asian descent.
Signs and Symptoms
Many Chronic Lymphocytic Leukemia patients do not have symptoms and a diagnosis is generally determined through various tests. Oftentimes, symptoms that present in Chronic Lymphocytic Leukemia patients are a result of the effects of the abnormal blood count due to the increase in mutated, unhealthy white blood cells. These symptoms usually occur over a prolonged period of time.
These are some signs and symptoms:
- Lethargy and fatigue/shortness of breath – caused by low red blood cell count, or Anaemia.
- Painless, swollen lymph nodes or glands in the groin, underarms or neck
- Chills and night sweats/fever – due to the increased risk of infections because the lymphocytes, which produce antibodies to fend of infections, are not functioning fully.
- Feeling of fullness or slight pain in the upper abdomen – caused by enlarged liver or spleen.
- Bruising easily or abnormal bleeding (nosebleeds or bloodied gums) – caused by Thrombocytopenia, a condition that occurs as a result of low platelet count.
A Complete Blood Count (CBC) Test measures the cells in a person’s blood, including red blood cells, white blood cells and platelets. Patients with Chronic Lymphocytic Leukemia usually present with a high white blood cell count and this may be accompanied by decreased red blood cell and platelet count.
If the test reveals a high white blood cell count, a peripheral blood smear will be conducted whereby a sample of blood is looked at under the microscope. In cases of Chronic Lymphocytic Leukemia, abnormal looking lymphocytes, or smudge cells, can be evident.
Flow Cytometry Test or Immunophenotyping
A crucial test in detecting Chronic Lymphocytic Leukemia, the flow cytometry test helps to establish whether the increase in lymphocytes is because of Chronic Lymphocytic Leukemia or other noncancerous factors, such as infections.
The Flow Cytometry Test is important in detecting Chronic Lymphocytic Leukemia because it is highly sensitive and able to determine several components of the cancer even if there is only a very slight increase in lymphocyte level.
Quantitative Immunoglobulin Test
As Leukemia cells are unable to make healthy antibodies – immunoglobulins – this is a test conducted to measure the concentration of these antibodies in the blood. If the level of immunoglobulin in the blood sample is low, there is an increased chance that the patient has advanced Chronic Lymphocytic Leukemia and may be susceptible to catching infections.
Fluorescent in situ Hybridization (FISH), IgHV mutation and next generation sequencing
In cases where Chronic Lymphocytic Leukemia is present, these tests will study the mutations that the Leukemia cells may harbor in order to predict the aggressiveness and prognosis of the cancer. These tests now inform the most appropriate therapy for the disease and allows tailoring of
Bone Marrow Biopsy
While blood tests provide the necessary information required when it comes to diagnosing Chronic Lymphocytic Leukemia, a bone marrow test will allow doctors to determine how advanced the Leukemia is and to decide on the form of treatment. Further bone marrow tests may also be done during or after treatment to ascertain the effectiveness of therapy and to measure minimal residual disease.