CLL INTRODUCTION: Age & Symptoms

Chronic lymphocytic leukemia (CLL) is a chronic form of leukemia; it was originally described in 1845 as a disease of elevated white cell count, swollen lymph nodes and enlarged liver and spleen. CLL is a result of an increased production of long-lived abnormal lymphocytes, a type of blood cells, which are generated in the bone marrow, invade the blood stream and accumulate in organs such as lymph nodes, liver and spleen.

CLL is common among the elderly. More than half of the patients are sixty-five years or older at the time of their diagnosis. This disease uncommonly affects individuals younger than fifty years old. The number of people affected by CLL is growing every year because of the aging of the U.S. population and the fact that CLL patients can live for many years. Survival is now prolonged as a result of improved treatment.

Until the mid 1990s, the majority of the patients were diagnosed once some of the symptoms of the disease became noticeable; today the majority of patients have their diagnosis made at the time of routine blood work part of an annual physical exam or upon follow up on other medical conditions. Routine blood work reveals an elevated white count. Based on the excess of lymphocytes, more specific tests need to be conducted to confirm the diagnosis as other diseases can also increase the lymphocyte count.

Clinicians have recently recognized many new symptoms that appear to be related to CLL. One of the more common complaints of CLL patients is the presence of fatigue; patients describe themselves as drained from energy. They require multiple rest periods during the day to perform their activities. This reduced energy does not appear to be necessarily related to the stage of the disease although it is commonly found in the early phase of CLL and appears to be more noticeable in women. As with fatigue, patients with CLL will often complain of difficulties in concentration and in performing complex tasks. While the exact cause of these symptoms is unknown, this is an area of active study. The symptoms may result from an immune reaction by normal lymphocytes to the persistence of the CLL cells.

The ability of CLL to interfere with patient's performance, ability to work and daily responsibilities and activities is very important because patients with this disease can live for many years and need specific recognition and intervention programs to reduce the burden of leukemia on their quality of life.

Age distribution (%) of new cases as reported by the National Cancer Institute (Surveillance, Epidemiology and End Results (SEER) data, 2000-2003).