Chronic Lymphocytic Leukemia

Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia is a type of blood cancer that occurs due to abnormalities in the bone marrow. The term 'chronic' in lymphocytic leukemia indicates that this disease develops slowly in the long term.

Bone marrow is a tissue located in the middle of the bone and functions to produce blood cells, one of which is lymphocytes . Lymphocytes themselves are one of the types of white blood cells that help the body fight infection.

In patients with chronic lymphocytic leukemia, the function of the bone marrow is disturbed. This causes the bone marrow to produce too many immature and abnormal lymphocytes. As a result, sufferers of this condition are susceptible to infection.

Although it develops slowly, symptoms can appear when the cancer begins to spread to the liver , spleen, or lymph nodes. If symptoms have appeared, the patient needs to get the right treatment right away to prevent serious complications.

Causes of Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia is caused by DNA changes or mutations in cells in the bone marrow. This mutation causes the bone marrow to produce too many abnormal and immature lymphocytes. However, the exact cause of the DNA mutation is not yet known.

Risk factors for chronic lymphocytic leukemia

There are a number of factors that can increase a person's risk of suffering from chronic lymphocytic leukemia, namely:

  • Aged more than 50 years
  • Male gender
  • Having a family that suffers from blood cancer
  • Often exposed to certain chemicals, such as herbicides or insecticides
  • Suffering from diseases that result in high levels of lymphocytes, such as monoclonal B-cell lymphocytosis

Symptoms of Chronic Lymphocytic Leukemia

In the beginning, chronic lymphocytic leukemia generally does not cause symptoms. New patients experience symptoms after suffering from this condition for a long time, or when the cancer has started to spread to the liver, spleen , or lymph nodes.

The following are some symptoms of chronic lymphocytic leukemia:

  • Fatigue
  • Weight loss
  • Loss of appetite
  • Swelling of the lymph nodes in the armpit, neck, stomach, groin, or other parts of the body
  • Shivering
  • Fever
  • Frequent infections
  • Excessive sweating at night
  • Abdominal pain or feeling full
  • Shortness of breath

When should you go to the doctor?

Immediately check yourself with a doctor if you experience the symptoms below continuously and do not improve:

  • Pale skin
  • Extreme fatigue
  • High fever
  • Red or purple spots on the skin
  • Easy bruising or bleeding
  • Enlargement of the spleen or liver

Diagnosis of Chronic Lymphocytic Leukemia

To diagnose chronic lymphocytic leukemia, the doctor will ask questions about the symptoms and complaints experienced by the patient, the patient's and family's health history, and the lifestyle the patient lives.

After that, the doctor will perform a physical examination, among other things by detecting swollen lymph nodes or enlargement of the spleen and liver.

To determine the diagnosis, the doctor can perform several further examinations, namely:

  • Blood tests , including a complete blood count, to find out the number of white blood cells (especially lymphocytes), red blood cells, platelets, and hemoglobin
  • Bone marrow aspiration and biopsy, to find out the cause of chronic lymphocytic leukemia, by taking blood and tissue samples from the bone marrow
  • Genetic tests, to detect changes in the TP53 or IgVH genes
  • Scans, such as X-rays, USGs, and CT scans , to find out the spread of cancer cells

Stages of Chronic Lymphocytic Leukemia

Based on the results of the examination that the patient has undergone, the doctor will determine the severity of the disease which is divided into 4 stages, namely:

  • Stage 0 The
    patient has too many lymphocytes in the blood, but does not experience certain physical symptoms or complaints.
  • Stage 1 The
    patient has too many lymphocytes in the blood and has swelling in the lymph nodes.
  • Stage 2
    Stage 2 is characterized by too many lymphocytes in the blood, swelling of the lymph nodes, and enlargement of the spleen and liver.
  • Stage 3 The
    patient has too many lymphocytes in the blood and too few red blood cells. The patient also experienced swelling of the lymph nodes, as well as enlargement of the spleen and liver.
  • Stage 4
    Stage 4 is characterized by too many lymphocytes in the blood, too few platelets and red blood cells ( thrombocytopenia and anemia), swelling of the lymph nodes, and enlargement of the liver and spleen

Treatment of Chronic Lymphocytic Leukemia

The treatment of chronic lymphocytic leukemia will be adjusted according to the examination results. If it is still classified as mild and does not cause symptoms, intensive treatment is not required. However, patients still have to regularly check themselves with an oncologist and undergo blood tests so that their condition is always monitored.

Intensive treatment will be given when symptoms appear or the patient's condition has worsened. Some actions that can be taken are:

  • Chemotherapy
    Chemotherapy is the administration of drugs, either by injection or orally, to kill cancer cells. The drug given can be a single drug, such as chlorambucil or fludarabine, or a combination of several drugs.
  • Target
    therapy Target therapy is also done by giving drugs. However, the drugs given in this therapy work to inhibit the proteins that cancer cells use to survive and grow. An example of a drug used in this therapy is rituximab.
  • Bone marrow transplantation
    This method is done by replacing the damaged bone marrow cells with healthy bone marrow from one's own or from a donor. Before bone marrow or stem cell transplantation, patients must undergo chemotherapy 1-2 weeks before.

It should be noted that the above methods can cause a variety of different side effects. For this reason, undergo routine examinations and consult with your doctor regarding steps that can be taken to reduce the risk of side effects.

Complications of Chronic Lymphocytic Leukemia

If you don't get the right treatment, chronic lymphocytic leukemia can cause complications, including:

  • Infections that occur repeatedly, generally in the respiratory tract
  • Disorders of the body's immune system so that the immune system even attacks healthy blood cells
  • A more aggressive cancer, namely B cell lymphoma or Richter's syndrome
  • Other types of cancer, such as skin cancer, lung cancer, and digestive tract cancer

Prevention of Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia can be prevented by changing controllable risk factors, such as smoking habits, exposure to harmful chemicals, stress , and unhealthy lifestyles. The way is to:

  • Consume a balanced nutritious diet, including vegetables and fruits
  • Exercise regularly
  • Maintain an ideal weight
  • Manage stress well
  • Get enough sleep and rest
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