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.
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