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  Chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL) is a blood cancer in which the body produces too many lymphocytes or white blood cells. The term chronic is used to describe the extremely slow progression of the disease.

Men are two times as likely to be diagnosed with chronic lymphocytic leukemia – seventy five percent of cases are diagnosed in individuals over the age of fifty. Clearly age is a more significant risk factor than gender. In the United States almost seventy-three hundred cases are diagnosed each year.

Chronic lymphocytic leukemia
Chronic lymphocytic leukemia


There are two types of CLL that are currently diagnosed. One type is T cell, which is controversial, since many experts deny that T-cell CLL exists. The other type is B-cell CLL. T-cell CLL is the rarer of the two forms of chronic lymphocytic leukemia. It is considered that most cases of T-cel lymphoma are actually large granular lymphocyte leukemia – which is a chromic disorder of the lymphoproliferative class of blood disorders. B-cell CLL is diagnosed in ninety-five percent of chronic lymphocytic leukemia cases. It appears in the bone marrow and the blood. It is very similar to small cell lymphocytic lymphoma (SLL) a form on non-Hodgkin lymphoma that primarily affects the lymph nodes. Some experts consider CLL and SLL to be the same disease.

Symptoms:

In the beginning stages of this disease, there are usually no signs or symptoms. The symptoms that do appear are non-specific and inconclusive. The symptoms are weight loss or loss of appetite, malaise, and fatigue during exercise, night sweats, and a pain or fullness below the ribs on the left sides, and fevers.

More obvious symptoms are present the more advanced the untreated chronic lymphocytic leukemia is. All blood cells are affected by this disease and depending on the severity of the affection, various symptoms may occur.

CLL causes a shortage of red blood cells in the body, which in turn leads to anemia, shortness of breath, tiredness and pallor. CLL causes a large white blood cell count, but the cells are not functioning normally. Even though there are a large number of cells, they cannot fight infection in the way normal blood cells. Platelets are designed to prevent and control bleeding. A shortage of platelets, known as thrombocytopenia results in frequent and severe nose bleeds, gum bleeding – even when just brushing teeth, and petechia – a small red pin prick rash that is actual minor bleeding below the surface of the skin.

CLL may cause bone pain, swelling of the liver and spleen, engorged lymph nodes (specifically found in the neck, underarm, stomach and groin. The enlarge spleen is responsible for the pain and full feeling patients feel on the left side of their bodies, below the ribs.

CLL patients are at risk for developing lymphoma, certain infections and secondary cancer.

Diagnosis:

Diagnosis is determined via blood test and bone marrow biopsy. A biopsy involves the withdrawal of bone marrow via a small needle. The marrow is microscopically evaluated for the presence of leukemic cells.

Treatment:

There is no cure for chronic lymphocytic leukemia, but it’s progression is extremely slow. Most people with CLL lead normal lives for many years, even decades after diagnosis. It is believed that early stage CLL require no intervention since it does not improve quality of life or survival rates. Chronic lymphocytic leukemia is a disease that is closely watched over time. When a patient’s quality of life is impacted by clinical symptoms or blood count, treatment is usually started. There are clinical staging systems which are used to determine the progression of the disease and when, with what and how the disease should be treated. Treatment for CLL is designed to control the disease and symptoms, and sadly not to cure it. CLL is treated with the usual leukemia treatments such as radiation therapy, chemo-therapy, biological therapy(immuno-therapy) and bone marrow transplant. Sometimes specific symptoms can be treated with surgery such as engorged lymph nodes or a swollen spleen.

The exact diagnosis and progression of the disease dictate how CLL will be treated. This is also taken into consideration with the preference of the patient and the experience of the doctor or treatment team. There are a great number of agents to choose from for treating CLL, with research to back up effectiveness. Bone marrow transplants are rarely performed as an initial treatment, but for recurring CLL.

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