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Diagnosis
An accurate diagnosis of the type of leukemia is important. The exact diagnosis helps the doctor to
- Estimate how the disease will progress
- Determine the appropriate treatment
After your doctor or clinician takes your blood, he or she sends it to a lab for a complete blood count (CBC), which shows the number of red cells, white cells and platelets in your blood.
Treatment
It's important that your doctor is experienced in treating patients with chronic leukemia or works in consultation with a chronic lymphocytic leukemia (CLL) specialist. This type of specialist is called a hematologist oncologist.
Types of CLL TreatmentCurrent therapies do not offer patients a cure for CLL, but there are treatments that help manage the disease. Doctors use several types of approaches and treatment for adults with CLL, some at different stages:
Chemotherapy and Drug Therapy
Beginning Treatment for CLLTreatment of CLL is started when symptoms develop that are associated with active disease. Before starting treatment, it is important to have another FISH test to see if there are any changes to the genes and/or chromosomes of the CLL cells.
Marty
The last time I gave blood was in June of 2016. I was set to start my fourth gallon when I was told by the volunteer my iron was too low. “Come back next time and eat some raisins before you come,” I was told. The next time was an iron failure again. I made an appointment with my PCP for my annual physical and he drew blood for a CBC. Much to my surprise, he called me the next evening at dinner time and said my white cells had some problems and I should see a hematologist/oncologist. He explained his brother had CLL, a possible diagnosis, and lives a normal life.
Treatment Outcomes
Treatment outcomes for people with CLL vary widely, and expected outcomes are influenced by the
- Stage of the disease
- Presence or lack of various factors associated with higher-risk disease
- Overall health of the patient
- Other considerations.
Current research suggests that newer treatment combinations and approaches may improve the length of survival. People with CLL should consult with their doctors to discuss individual potential outcomes. For survival statistics, click here.
Related Diseases
Chronic lymphocytic leukemia (CLL) shares some similar features and symptoms with other closely related types of leukemia.
Clinical Trials
Taking part in a clinical trial may be the best treatment choice for some chronic lymphocytic leukemia (CLL) patients. Clinical trials are under way to improve remission rates for CLL. Today's standard treatments for cancer are based on earlier clinical trials. The Leukemia & Lymphoma Society continues to invest funds in CLL research.
Click here to read more about clinical trials.
Combination Targeted Therapy in Chronic Lymphocytic Leukemia
Targeted therapies have replaced chemoimmunotherapy in chronic lymphocytic leukemia (CLL). We previously reported that combined BTK inhibitor (ibrutinib) and BCL2 antagonist (venetoclax) is highly synergistic. In this proposal, we will conduct a phase II trial of combined non-covalent BTK inhibitor (pirtobrutinib) with venetoclax and obinutuzumab in patients with untreated CLL with primary endpoint of marrow MRD. We will perform BH3 profiling and scRNAseq and correlate with clinical outcomes.Watch and Wait
Not all CLL patients need to start treatment immediately. “Watch and wait,” also called "active surveillance," is a valid treatment approach that means your doctor will watch your condition but not give you treatment unless you have signs or symptoms that appear or change. This approach includes:
Teresa
I was diagnosed in 2009 with chronic lymphocytic leukemia (CLL). Upon diagnosis, perhaps the greatest shock was becoming aware that I knew so little about cancer, so little about the medical system, and how one needs to go about a process of self-education regarding their disease.
My diagnosis occurred at the Simon Cancer Center, a part of the Indiana University Health System. I was fortunate to have a neighbor who is a nurse practitioner at this cancer center. She intervened when she found out that a routine shoulder MRI revealed multiple enlarged lymph nodes.
Relapsed and Refractory
Relapsed CLL is the term for disease that returns after it has been in remission for more than six months.
Refractory disease is the term for CLL that does not result in remission after initial therapy.
Improving BTK Inhibitor Therapy in Chronic Lymphocytic Leukemia Through Rational Combination Strategies
Ibrutinib is a targeted oral treatment for CLL that is safe and highly effective, however it must be given indefinitely which leads to chronic side effects and allows resistance to develop. We are conducting two clinical trials that add a second drug to ibrutinib to eliminate the remaining leukemia or ibrutinib-resistant leukemia cells. If these trials are successful, people taking CLL with or without resistance may be able to stop treatment in remission after taking an ibrutinib combination.Signs and Symptoms
Many people are diagnosed with CLL even though they do not have any symptoms. The disease may be suspected because of abnormal results from blood tests that were ordered either as part of an annual physical or a medical examination for an unrelated condition. An unexplained elevated white blood cell (lymphocyte) count is the most common finding that leads a doctor to consider a CLL diagnosis.
Generally, CLL symptoms develop over time. As the disease progresses, a person may experience
Bob
I thought I was super healthy.
It was October 2017, and I had just run a half marathon a few days before. I went to get my blood tested to see if I still was eligible to donate a kidney to a friend who needed one. Four years earlier, I had gone through all the testing and was approved to be a donor for her, but her kidney function had improved enough that she didn't need a transplant right then. By late summer 2017, her condition had deteriorated, so I went back in to restart the process.
Emma
My dad, Panos, was diagnosed with kidney cancer when I was in the fourth grade. His cancer progressed very fast, and he passed away in 2019. My mom, Tricia, was diagnosed with chronic lymphocytic leukemia (CLL) shortly after. She has had many doctor appointments during this time, and I am so excited to be able to support her through it all and help raise awareness! I’ve spent most of my life surrounded by cancer, growing up visiting my grandma and dad in the hospital at a young age, and I am hoping to make a change by raising money for research and more.
Barbara
While enjoying a 2021 spring vacation with my husband in Kentucky, I began to feel severe pain in my right arm. Over several hours, the pain increased, but I didn’t want to interrupt our vacation plans with a hospital visit. By late evening, my husband could tell that we must get to an emergency room PRONTO! But where in this large city can we find one? We finally stopped at a Home Depot store and asked for directions. After searching on darkened streets in a strange city, we found the emergency entrance to a hospital.
Yeah!
Stephanie
I was diagnosed with stage 2 Hodgkin lymphoma (HL) in 2000 and had seven months of chemotherapy (ABVD) and 20 rounds of radiation. I have not had a reoccurrence of HL, but in 2014, I was diagnosed with chronic lymphocytic leukemia (CLL). I see my oncologist every four months to check my white blood count, and so far, I am still in a watch-and-wait situation. I work full-time in a high-level, stressful job, have two children, and thankfully, have the energy to do it all and have not had to resort to any treatment yet.
Glenn
I was diagnosed with CLL in 2010 after feeling tired all the time, bruising easily, significant joint pain, a hot mess. I was told I could be treated but never cured. I survived an earlier cancer via radiation therapy where I was over radiated. I had never been so sick in all my life. While I don't ignore my condition I've decided to live best I can. I have a loving family and friends and a good career. I stay active as a volunteer firefighter (my way of giving back in honor of 911 victims as I was on the NYFD career list in 1999), home improvements, and attending family functions.
Wendell
Wendell Ison was diagnosed with chronic lymphocytic leukemia (CLL) on June 6, 2006. It was through his own battle that he decided to create the team known as "Wendell's Warriors" as a way to give back and make a difference in people's lives by raising money for the Leukemia Lymphoma Society (LLS).
Don
My Uncle Don Parker is my hero, and my favorite uncle as well, who just never gave up on himself and others. And when he got sick and passed away with chronic lymphocytic leukemia (CLL) in 2001, I was inspired to do a Team In Training (TNT) marathon in Honolulu, Hawaii, that same year in December 2001. I was only able to do 15 miles then, but now I've done eight TNT half marathon events, and this summer it will be my 20th anniversary for doing TNT.
Jeff
A little over two years ago, I was diagnosed as having chronic lymphocytic leukemia (CLL). I was shocked and devastated by the news and immediately began seeing an oncologist. My team from the cancer center has been uplifting, positive, and supportive from the very beginning! They have been successfully treating my cancer and have taught me not to fear my disease.
Tracey
I was diagnosed with chronic lymphocytic leukemia (CLL) in 2021 after a routine physical after my 50th birthday. It was a complete shock, and I was scared and unsure of what my future would look like. With the help of my doctors and The Leukemia & Lymphoma Society (LLS), I feel prepared to make informed decisions about my future. I participate in medical research studies and intend to join a clinical trial (that a clinical nurse at LLS told me about) when I need treatment.
Michele
I was recently diagnosed with chronic lymphocytic leukemia (CLL). My mom passed away from pulmonary fibrosis right before Thanksgiving 2022. She never smoked and had none of the risk factors that led to that type of disease. So, I thought I would get a physical to make sure I was healthy. I have a 2½-year-old daughter, and I am an older mom, so I figured I should make sure my lungs were healthy. I didn't even have a primary care physician, so I asked my good friends for a recommendation.
Jaime
My name is Jaime Fernandez and I am a Clinical Social Worker with UCI Health. I have the pleasure and honor of working with individuals diagnosed with blood cancers. Supporting my patients and their loved ones as they navigate these diagnoses has become my driving force. I have been a social worker for nine years now and it wasn't until I moved to UCI's Chao Family Comprehensive Cancer Center, and began working with this population, that I gained a new appreciation for what I do.