What Chronic Lymphocytic Leukemia symptoms suggest a patient needs treatment?

A fellow caregiver asked...

What Chronic Lymphocytic Leukemia symptoms beyond high white blooc ount, suggest a patient needs treatment?

Expert Answer

Linda Ackerman, R.N. has clinical experience in oncology, women's health, and medical nursing. She has been practicing for more than 20 years and is a licensed registered nurse in both Florida and Wisconsin. In addition, she serves as a board member of Breast Cancer Recovery and the Wisconsin Cancer Council.

Thank you for your question. The diagnosis of CLL should be based on a number of clinical indicators beyond a high white blood count.

I will provide some additional items as an overview to help with my response to your question.

CLL is a slow developing leukemia.

CLL is typically diagnosed from a variety of tests such as:

"¢ Blood cell count, a person with CLL will have a high lymphocyte count ( white blood cells) and may also have a low red blood count or low platelet count

"¢ Blood cell examination called a flow cytometry or immunophenotyping

"¢ Immunoglobulin Test.

"¢ Bone marrow aspiration

"¢ FISH, (fluorescence in situ hybridization test) this test looks at any chromosome changes.

Treatment, planning and staging:

"¢ Stage of the CLL (low, intermediate or high risk)

"¢ Physical exam and lab test results

"¢ Person's overall health

"¢ Person's age (for some treatment

Goal of CLL therapy:

"¢ Slow the growth of CLL cells

"¢ Provide long periods of remission (when there are no signs of CLL and/or people feel well enough to carry on their day-to-day activities)

"¢ Help people to feel better if they have infections, fatigue or other symptoms.

Treatment plan may depend on the following factors:

"¢ Stage of the CLL (low, intermediate or high risk)

"¢ Physical exam and lab test results

"¢ Person's overall health

"¢ Person's age (for some treatments).

CLL treatment options:

"¢ Watch and Wait- a doctor observes a person's condition with physical exams and lab tests. The doctor does not treat the person with drugs or to start treatment and the type of treatment to have.

"¢ Drug Treatment -People who have intermediate- and higher-risk (faster-growing) CLL are usually treated with combination chemotherapy /or monoclonal antibody therapy.

Supportive Care - Supportive care is given to prevent or treat CLL symptoms and/or treatment side effects. Supportive care for CLL may include

"¢ Antibiotics

"¢ Blood transfusions or red cell growth factors used to increase the red cell count.

"¢ Growth factors used to improve low white cell counts.

I also think it is important to choose a doctor who specializes in treating CLL and who knows about the most up-to-date treatments. This type of specialist is usually called a "hematology oncologist." I hope you find this information helpful.