Chronic lymphocytic leukemia is a type of cancer of white blood cells (B lymphocytes) and bone marrow, the organ in which blood cells are produced. B lymphocytes are cells involved in combating infections, therefore belonging to the immune system.
In chronic lymphocytic leukemia, the disease progresses at a slower pace than other more aggressive types of leukemia. The term lymphocytic comes from the fact that the cells affected by the disease are white blood cells or lymphocytes.
What are the causes of chronic lymphocytic leukemia?
It is not known for sure what causes chronic lymphocytic leukemia. What is known is that something causes a genetic mutation in the DNA of blood-producing cells, which continue to grow and divide, while the normal healthy cell stops dividing and dies, after a specific time (hours or days, according to the case). Thus, the number of white blood cells increases significantly.
It is not clear what causes these mutations, but they cause the production of unusual lymphocytes. It is also known that chronic lymphocytic leukemia is not a hereditary disease.
Chronic Lymphocytic Leukemia (CLL) Treatment Cost in India is mostly dependent on the cost of chemotherapy and drugs. The cost of chemotherapy at best private hospitals ranges from INR 1.5 lakhs to 2.5 lakhs or USD 2080 to 3470 for one cycle. Complete therapy regimen may include up to 6 cycles over 3-5 months. The most exceptional oncology hospitals in India are Apollo Speciality Cancer Hospital, Chennai and Kokilaben Dhirubhai Ambani Hospital in Mumbai. Although cancer drugs are expensive abroad, they are available in India at 20% of the price due to the widespread manufacture of generics.
What is the physiological mechanism of chronic lymphocytic leukemia?
When chronic lymphocytic leukemia occurs, the bone marrow produces an excess of immature cells that develop into abnormal white leukemic cells. In addition to being ineffective, these abnormal lymphocytes continue to live and multiply exaggeratedly, causing a significant increase in lymphocytes in the blood (lymphocytosis).
These abnormal lymphocytes may accumulate in the blood and in certain organs, such as lymph nodes, liver, spleen, central nervous system, and testes, causing them to malfunction. They can also force immature healthy cells out of the bone marrow and interfere with the normal production of these cells.
What are the main clinical features of chronic lymphocytic leukemia?
Chronic lymphocytic leukemia occurs most commonly in the elderly, over 60, and the chances of cure are lower than in the acute form. Chronic lymphocytic leukemia develops so slowly that the affected person may, at first, not show signs or symptoms. A large number of patients with this condition remain asymptomatic for a long time. Often, the first sign of chronic lymphocytic leukemia is an unexplained leukocytosis, found on a routine blood test.
When present, early signs and symptoms of the disease may include enlarged but painless lymph nodes in the neck, armpits, abdomen, or groin, fatigue, fever, pain in the upper left part of the abdomen, enlarged spleen, night sweats, weight loss, and frequent infections.
As the disease progresses, the patient may develop severe anemia, due to reduced production of red blood cells, bleeding due to low platelet count and infections due to immune deficiency.
How does the doctor diagnose chronic lymphocytic leukemia?
Exams and procedures necessary to diagnose chronic lymphocytic leukemia include blood tests, showing white blood cells that are increased in number and morphologically anomalous; examination of the bone marrow, by aspiration of the same with needle (myelogram); analysis of images such as radiography, computed tomography or ultrasonography and testing of the spinal fluid by means of a lumbar puncture. Further exams may be added, depending on the peculiarities of each clinical case.
How does the doctor treat chronic lymphocytic leukemia?
Chronic lymphocytic leukemia does not have a definitive cure. However, there are treatments to help control the disease. These treatments may not even be needed in the early stages. Early therapies do not increase the survival of people with early chronic lymphocytic leukemia. At this stage of the disease, doctors would only monitor the condition but not treat.
As the chronic lymphocytic leukemia progresses to an advanced stage, treatment options may include chemotherapy as well as bone marrow transplantation and immunotherapy drugs.
As drugs have become more developed, bone marrow transplantation has become less frequent. Treatments for chronic lymphocytic leukemia depend on many factors including age and general health of the patient.