Chronic Lymphocytic Leukemia
April 19, 2024
This page was reviewed under our medical and editorial policy by Guido Marcucci, M.D., Chair, Department of Hematologic Malignancies Translational Science, City of Hope Duarte
Chronic lymphocytic leukemia, also called chronic lymphoblastic leukemia or CLL, is a type of blood cancer that begins in white blood cells. CLL is often a slow-growing cancer that may not cause symptoms, so it is sometimes found via a blood test performed for other reasons.
A number of treatment options are used, and as doctors learn more about the genetics of CLL, new therapies for the disease are being made available.
CLL is a type of cancer that begins in the lymphocytes. These are a type of white blood cell found in the bone marrow that help the body’s immune system fight off infection. When leukemia cells build up, the body has less space for healthy cells, and it becomes harder for the immune system to function properly.
CLL is the most common type of leukemia in adults. According to the American Cancer Society, about 20,700 cases of chronic lymphocytic leukemia are diagnosed in the United States each year.
CLL does not always cause symptoms, and it is often discovered by a routine blood test. When symptoms do occur, they may be vague in nature and may appear to result from other, more common health conditions.
Some of the most common symptoms of CLL include fatigue, unexplained weight loss, fever, night sweats, weakness and feeling full even without eating a big meal. When CLL spreads to other areas of the body, its symptoms are often linked to low blood cell counts, causing conditions such as anemia, as well as an increased risk of infections.
Doctors use a number of diagnostic tools for CLL, including physical exams, blood tests, bone marrow aspiration and biopsy, lumbar puncture and lymph node biopsy.
If CLL is discovered, additional testing will be done to help determine the cancer’s stage and subtype — information that is key to creating a personalized treatment plan. Blood cancers such as CLL don’t form solid tumors, so they are staged using a different method. Staging is determined by factors such as blood cell counts and imaging test results.
Different CLL treatment options are available. Since CLL is often a slow-growing cancer, many patients may begin with active surveillance — also called watchful waiting — in which doctors closely monitor the cancer and begin active treatment only if it worsens.
For patients in need of active treatment, chemotherapy is a common option. Radiation therapy is a less common treatment for CLL.
Bone marrow transplants may also be performed to replace leukemia-containing bone marrow with new stem cells that become healthy tissue.
American Cancer Society (2018, May 10). What Is Chronic Lymphocytic Leukemia?
https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/about/what-is-cll.htmlAmerican Society of Clinical Oncology (2017, October). Leukemia - Chronic Lymphocytic - CLL: Types of Treatment.
https://www.cancer.net/cancer-types/leukemia-chronic-lymphocytic-cll/types-treatmentAmerican Cancer Society (2024, January 17). Key Statistics for Chronic Lymphocytic Leukemia.
https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/about/key-statistics.htmlNational Cancer Institute (2024, January 19). Chronic Lymphocytic Leukemia Treatment (PDQ) - Patient Version.
https://www.cancer.gov/types/leukemia/patient/cll-treatment-pdq#American Cancer Society (2018, May 10). How Is Chronic Lymphocytic Leukemia Diagnosed?
https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/detection-diagnosis-staging/how-diagnosed.htmlAmerican Cancer Society (2018, May 10). How Is Chronic Lymphocytic Leukemia Staged?
https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/detection-diagnosis-staging/staging.htmlAmerican Society of Clinical Oncology (2017, October). Leukemia - Chronic Lymphocytic - CLL: Introduction.
https://www.cancer.net/cancer-types/leukemia-chronic-lymphocytic-cll/introduction
Our Chronic Lymphocytic Leukemia Expertise
City of Hope has been named a best hospital for cancer by U.S. News & World Report for over a decade. As a founding member of the National Comprehensive Cancer Network, our doctors also help develop and improve evidence-based leukemia treatment guidelines for patients nationwide.
Program Highlights:
- A multidisciplinary team of specialists – including hematologists, medical and radiation oncologists, scientists, supportive care experts, and other professionals – who work together to provide coordinated, personalized care for you and your loved ones.
- The Gehr Family Center for Leukemia is home to a team of basic scientists whose laboratory research focuses on furthering our understanding of the causes of leukemia (leukemogenesis) and developing new disease-specific therapeutics.
- Comprehensive molecular profiling and risk assessment tests that can help identify treatments that will produce the best outcomes.
- A world-class bone marrow and stem cell transplant program with better-than-expected survival outcomes for over 10 years.
- Leading-edge clinical trials for leukemia that are unavailable elsewhere, including CAR T cell immunotherapy, mutation-specific drugs, and novel stem cell transplant regimens.
- Total marrow irradiation can target radiation therapy to bone marrow while minimizing exposure to healthy tissues and organs.
- Specialized observation programs for slow-growing leukemia subtypes allow our doctors to deliver timely therapies when they are the most effective.
- A long-term follow-up program to minimize the risk of recurrence and improve the quality of life for leukemia survivors.
City of Hope is one of the few facilities designated a comprehensive cancer center by the National Cancer Institute.
Our developments in the areas of breakthrough cancer drugs, bone marrow transplants and CAR T cell therapy are recognized internationally.
Our leadership in research and innovation continually enhances our ability to provide novel and differentiated approaches to cancer care.