Synonyms in a broader sense
CLL, leukemia, white blood cancer
Definition
CLL (chronic lymphocytic leukaemia) is characterized by an uncontrolled growth of mainly mature stages of lymphocyte (lymphocyte) precursor cells, i.e. precursors of white blood cells. However, these mature cells are incapable of immune defence. The so-called B-lymphocytes are mainly affected, rarely the so-called T-lymphocytes (5%). Get more general information about white blood cells here
Frequency
Strictly speaking, CLL is a lymphoma and not a leukemia. Nevertheless, chronic lymphatic leukemia is the most common type of leukemia overall. It mainly affects older patients (over 60 years of age). Although older people are often affected, children can also develop CLL.
Causes
It is still largely unknown why the disease develops. Nevertheless, some risk factors have been linked to the disease. These include the high age of the patients, genetic factors and various environmental factors, such as chemical solvents.
Symptoms
In chronic lymphocytic leukemia, lymph node enlargements occur, e.g. in the armpits or neck, or invisibly, in the abdominal cavity. At the beginning of the disease, a performance kink, which is typical for cancer diseases, is observed. The motivation decreases, the patient is no longer as efficient as before, especially during sports, the patients notice significant limitations.
There is a certain tendency to sweat, especially at night. A strong unintentional weight loss within a short time, strong itching and frequent infections can be observed. Paleness is also a common symptom.
How can chronic lymphatic leukemia be diagnosed?
Often the disease progresses over a long period of time without symptoms and is therefore often discovered late or even by chance. Possible complaints can be so-called “B-symptoms”. These include night sweats, unwanted weight loss and fever.
However, these are quite unspecific and occur in many malignant cancers. Those affected often notice painless enlargement of the lymph nodes. Since the leukemia cells can also attack the liver and spleen, patients often have unspecific upper abdominal complaints, such as “pulling” or “pushing”.
Furthermore, CLL can cause chronic itching (pruritus) or skin rash (urticaria). Particularly in advanced stages, those affected tend to suffer from frequent, severe infections. These can include bacterial infections, but also a pronounced herpes virus attack.
In some cases, painless swelling of the parotid and lacrimal glands can occur (Mikulicz syndrome). The doctor treating you can usually identify CLL by a blood test. Under the microscope, typical, altered blood cells can then be identified. Basically, however, the symptoms of the disease are unspecific, so that much more often much more harmless diseases “are behind” it!
Diagnosis
In chronic lymphocytic leukemia there are some relatively characteristic changes in the blood or laboratory values. Typical is first and foremost “leukocytosis”. This is an abnormal increase in white blood cells.
In CLL, lymphocytes, a subtype of white blood cells, are particularly elevated. This can be explained, among other things, by the prolonged survival time of the “malignant” leukemia cells. To put it simply, these are “counted” as lymphocytes during blood analysis.
In chronic lymphatic leukaemia, normal, healthy blood cells are often displaced. As a result, a decrease in red blood cells (anemia) and blood platelets (thrombocytopenia) can be observed. In addition to the laboratory analysis of blood components, the examination of the blood smear under the microscope plays an important role.
Typical here is, for example, an increased number of mature, small lymphocytes or “Gumprecht-Kernot shadow”. To further characterize CLL, immunophenotyping is used. In this special examination, various features on the surface of the leukemia cells are examined.
Thus it is possible to form different subgroups of the disease and to optimize therapy accordingly. Blood sampling: Usually there is an increase in the number of white blood cells (leukocytosis). In addition, parameters are also examined here that indicate an increased cell turnover (e.g. uric acid).
However, an increase in white blood cells alone is not proof of CLL, as white blood cells play an important role in the immune defence and therefore also occur in increased numbers in the case of inflammation or infection. Blood smear: Some drops of blood are used to analyse the blood under the microscope. So-called Gumprecht’s deepest shadows are not conclusive, but indicate CLL (chronic lymphatic leukemia).
They are “burst” cells, which burst due to the large number of cells when they are spread out. A bone marrow biopsy is a tissue removal of bone marrow. This biopsy is then also analysed under the microscope. With the help of layered x-rays, known in the technical jargon as computer tomography, and ultrasound, lymph node enlargements and organ enlargements, typically enlargements of the spleen and liver, are detected.
