Chronic lymphatic leukemia – symptoms, treatment
Chronic lymphatic leukemia (CLL) is a malignancy arising from the proliferation and accumulation of a clone of small lymphocytes, immunologically incompetent (in most cases there are proliferating B lymphocytes).
This condition occurs in preference to persons aged 50-70 years, under 40 years is exceptional.
Causes of chronic lymphatic leukemia
The etiology of this type of leukemia has not yet been fully elucidated, but are considered to have an important role in the genesis of the disease the exposure to toxic agents and ionizing radiation. A more important factor is the genetic factor, showing increased susceptibility of the descendants of patients with chronic lymphatic leukemia to develop a range of malignancies.
Chronic lymphatic leukemia Symptoms
From the clinical point of view, this disease has an insidious onset, a long time is asymptomatic.
Symptoms are progressive accentuated. There are described very slow-moving forms and very fast-moving aggressive forms (T lymphocyte leukemia has a more severe evolution).
Signs and symptoms that characterize this condition are:
- a large number of generalized adenopathies (enlarged lymph nodes), symmetric – the lymph nodes are mobile, painless;
- splenomegaly (spleen volume growth) – moderate or bulky and can produce a series of compression;
- hepatomegaly (enlarged liver) – is only in half the cases;
- tonsillar hypertrophy and internal lymph nodes packages causing compressions on neighboring organs;
As general non-specific symptoms, the patient may present fatigue (reduction of energy and performance of the body), weight loss, loss of appetite, profuse sweating during night.
Analyses for chronic lymphatic leukemia
For diagnosis there can be made the following investigations:
- Peripheral blood examination – very high WBC (20,000-300.000/mmc), lymphocytes are very increased (over 5000/mmc) – important diagnostic criterion, anemia, thrombocytopenia (low platelets);
- Bone marrow examination – large number of cells in the marrow with lymphocytosis (increased number of lymphocytes);
Other investigations that can be performed are those for diagnosis of complications (compression syndromes due splenomegaly or increased lymph nodes) like imaging tests (chest radiograph, abdominal ultrasound, computed tomography, bone radiography), urinalysis, urine culture (for diagnosis of possible infection ), liver tests (dosing the transaminases), alkaline phosphatase (for liver infiltration with leukaemic cells), kidney tests (urea, creatinine, uric acid are frequently altered), ESR (increased in infections), coagulation tests.
Chronic lymphatic leukemia has the longest evolution of all leukemias. The main complications that can occur during evolution are:
– Infections – are due to immune deficiency;
– Bone marrow failure – infections and bleeding are two of the consequences of insufficient bone marrow;
– The second neoplasia – can appear after chemotherapy;
– Abdominal compressions phenomena – due to adenopathy or bulky splenomegaly;
– Leucostasis (white blood cell congestion in the capillaries where blood clots can cause obstructions);
Chronic lymphatic leukemia Treatment
Treatment should be adapted to the stage. Therapeutic means that can be used are chemotherapy, corticosteroid therapy, radiation therapy (for the giant spleen or large lymph nodes), bone marrow transplantation or stem cell, auxiliary treatment (antibiotics for infections, Allopurinol – in case of hyperuricemia). It can used interferon or interleukin-2.