What is chronic lymphocytic leukaemia (CLL)?

Chronic lymphocytic leukaemia (CLL) is the most common type of leukaemia found in Australia. It tends to develop slowly, so it’s possible to have CLL for years without noticing any symptoms or needing treatment.

Chronic lymphocytic leukaemia (also known as chronic lymphatic leukaemia) is a type of blood cancer. 'Chronic' means it tends to develop slowly, and 'lymphocytic' means it affects cells called lymphocytes.

CLL affects B-lymphocytes, or B-cells, which are part of the immune system. If you have CLL, your body makes a large number of abnormal B-cells, crowding out normal blood cells and causing a range of symptoms.

It is almost always adults who get CLL, and the risk of getting it increases with age. Men are twice as likely as women to get CLL.

What are the symptoms of CLL?

Some people have no symptoms of CLL. You can have the condition and not know until it is discovered through a blood test.

But it is possible to have problems that include:

• swelling of your liver and spleen, which can cause pain or discomfort under your ribs
• swelling of the lymph nodes (glands) in your neck, underarms or groin
• feeling very tired
• feeling short of breath
• bruising or unexplained bleeding
• getting infections regularly
• fever or high temperature despite not being sick
• sweating a lot at night
• losing weight

If you are concerned about any symptoms, you should see your doctor.

How is CLL diagnosed?

To diagnose CLL, your doctor will ask about your symptoms, examine you, and do some blood tests. If CLL is suspected, you might be referred to a haematologist, a specialist who treats conditions of the blood and the organs that make blood.

You might be asked to have other tests, which could include:

• imaging tests, such as CT scans, x-rays or ultrasound
• a bone marrow biopsy, which involves using a needle to take marrow from a bone, usually the hip bone
• taking a sample from a lymph node

How is CLL treated?

For many people with CLL, the condition has little impact on their lifestyle or general health for years.

Many people diagnosed with CLL do not need treatment straight away, if at all. Instead, your doctor might suggest you have 'active monitoring', which involves having regular check-ups and blood tests to monitor your health and any symptoms.

If there are signs the disease is getting worse or your symptoms are causing you problems, you might need active treatment. This usually means getting:

• chemotherapy (receiving anti-cancer medication)
• targeted therapies, such as monoclonal antibodies, which help your immune system fight the cancer
• a combination of these treatments

On rare occasions, a stem cell transplant might be used. This is usually only an option in young people with aggressive CLL, because of the risks associated with this type of treatment.

You can also get therapies to help relieve some of the symptoms of CLL. These are called supportive therapies, and include antibiotics and corticosteroids.

Living with CLL

If you have been diagnosed and treated for CLL, you might need to take some time to adjust to any physical and emotional changes. You might also want to re-evaluate things like your workload, and to establish a new routine.

CLL can be treated but not cured, so once you are diagnosed, you will need to have the condition monitored for the rest of your life. Also, when you have CLL, you are at a higher risk of some other conditions such as skin cancer, so regular check-ups with your doctor are a must.

More resources

• Contact your local Cancer Council for more information.
• Leukaemia Foundation provides blood cancer information and practical support.
• Lymphoma Australia educates and supports people diagnosed with lymphoma.