Materiały źródłowe

• #1 Chronic Lymphocytic Leukemia (CLL): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/199313-overview

  Chronic lymphocytic leukemia (CLL) is a monoclonal disorder characterized by a progressive proliferation and accumulation of mature yet functionally incompetent lymphocytes. CLL is the most common form of leukemia found in adults in Western countries. Some patients die within several years of diagnosis, usually due to complications from CLL, but most patients survive for at least five years. […] Patients with CLL present with a wide range of signs and symptoms. The onset is insidious, and it is not unusual for CLL to be discovered incidentally when a blood cell count is performed for another reason; 25-50% of patients will be asymptomatic at time of presentation. Signs and symptoms include the following: Enlarged lymph nodes, liver, or spleen; Recurrent infections; Loss of appetite or early satiety; Abnormal bruising (late-stage sign); Fatigue; Night sweats.

• #2 Chronic Lymphocytic Leukemia – Lymphoma Research Foundation

  https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/cll/

  Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are cancers that affect lymphocytes. […] Many patients with CLL/SLL do not have any obvious symptoms of the disease. Their doctors might detect the disease during routine blood tests and/or a physical examination. For others, the disease is detected when symptoms occur and the patient goes to the doctor because he or she is worried, uncomfortable, or does not feel well. CLL/SLL may cause different symptoms depending on the location of the tumor in the body. The symptoms of CLL/SLL include a tender, swollen abdomen and feeling full even after eating only a small amount. Other symptoms can include fatigue, shortness of breath, anemia, bruising easily, night sweats, weight loss, and frequent infections. However, many patients with CLL/SLL will live for years without symptoms.

• #3 Chronic lymphocytic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_lymphocytic_leukemia

  Chronic lymphocytic leukemia (CLL) is a type of cancer that affects the blood and bone marrow. In CLL, the bone marrow makes too many lymphocytes, which are a type of white blood cell. In patients with CLL, B cell lymphocytes can begin to collect in their blood, spleen, lymph nodes, and bone marrow. These cells do not function well and crowd out healthy blood cells. CLL is divided into two main types: Slow-growing CLL (indolent CLL) and Fast-growing CLL. […] Many people do not have any symptoms when they are first diagnosed. Those with symptoms (about 5-10% of patients with CLL) may experience the following: Fevers, Fatigue, Night sweats, Unexplained weight loss, Loss of appetite, Painless lymph node swelling, Enlargement of the spleen, and/or A low red blood cell count (anemia). These symptoms may worsen over time.

• #4 Chronic Lymphocytic Leukemia: Slow-Appearing Symptoms

  https://www.verywellhealth.com/chronic-lymphocytic-leukemia-7551732

  Most of the time, people diagnosed with chronic lymphocytic leukemia do not have symptoms. Its often found based on blood tests done for other reasons. […] As the disease progresses, the defective cells grow and spread to the lymph nodes, liver, and spleen. […] Bone marrow in CLL makes new, abnormal lymphocytic white blood cells faster than usual. They live longer than they should and crowd out normal cells. As the bodys abnormal white blood cells build up, so do the signs and symptoms of advanced CLL. […] Many people with CLL do not die of it. Only about one-third need treatment. Many are older (the average age at diagnosis is 70), and often, because the cancer is slow-growing, they may die from other causes before needing treatment. […] If chronic lymphocytic leukemia advances and needs treatment, it can be tough to cure. But as new therapies are developed, many people can live years without their disease worsening.

• #5 Chronic Lymphocytic Leukemia (CLL): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/199313-overview

  Chronic lymphocytic leukemia (CLL) is a monoclonal disorder characterized by a progressive proliferation and accumulation of mature yet functionally incompetent lymphocytes. CLL is the most common form of leukemia found in adults in Western countries. Some patients die within several years of diagnosis, usually due to complications from CLL, but most patients survive for at least five years. […] Patients with CLL present with a wide range of signs and symptoms. The onset is insidious, and it is not unusual for CLL to be discovered incidentally when a blood cell count is performed for another reason; 25-50% of patients will be asymptomatic at time of presentation. Signs and symptoms include the following: Enlarged lymph nodes, liver, or spleen; Recurrent infections; Loss of appetite or early satiety; Abnormal bruising (late-stage sign); Fatigue; Night sweats.

• #6 Chronic lymphocytic leukemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-lymphocytic-leukemia/symptoms-causes/syc-20352428

  Chronic lymphocytic leukemia most commonly affects older adults. […] Many people with chronic lymphocytic leukemia have no symptoms at first. Signs and symptoms might develop as the cancer progresses. They might include: Enlarged, but painless, lymph nodes, Fatigue, Fever, Pain in the upper left portion of the abdomen, which may be caused by an enlarged spleen, Night sweats, Weight loss, Frequent infections. […] Make an appointment with your doctor if you have any persistent signs and symptoms that worry you.

• #7 Chronic Lymphocytic Leukaemia (CLL) Symptoms | Cancer Council NSW

  https://www.cancercouncil.com.au/chronic-lymphocytic-leukaemia/symptoms/

  Many people with chronic lymphocytic leukaemia (CLL) have no symptoms. Often the disease is diagnosed after a routine blood test shows a high white blood cell count. In the early stages, symptoms tend to be mild and develop slowly. […] Symptoms may include: swollen lymph nodes in the neck, underarms or groin […] pain and/or feeling full after eating only a small amount – caused by an enlarged spleen […] tiredness – caused by a low red blood cell count (anaemia) […] frequent and persistent infections – caused by low levels of normal white blood cells (neutropenia) leading to lowered immunity or few protective antibodies to help fight infections […] bruising or bleeding – caused by low levels of platelets (thrombocytopenia) […] drenching night sweats […] high temperature (fever) without any other signs of infection […] unexplained weight loss. […] Not everyone with these symptoms has chronic leukaemia, but if you have any of these symptoms, it’s best to see your doctor.

• #8 CLL Stages: What Living With Stages 0-4 Is Like | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/stages-of-chronic-lymphocytic-leukemia

  You may experience different symptoms depending on the stage of CLL you’re living with. […] People in stage 0 may have no symptoms of leukemia. Lymphocytosis is usually detected on routine blood tests. Any symptoms experienced are very few and usually don’t interfere with daily life. One MyLeukemiaTeam member with stage 0 CLL explained, The only symptom I have so far is that I tire a little quicker than I used to. […] Symptoms are still minimal at stage 1. You may notice enlarged lymph nodes but otherwise feel close to normal. You may experience more fatigue and begin to have night sweats. […] In stage 2 CLL, there is lymphocytosis, and the spleen is enlarged. The liver and lymph nodes may or may not be enlarged, and blood test results show that red blood cell and platelet counts are near normal. An enlarged spleen or liver could cause some abdominal pain.

• #9 Staging chronic lymphocytic leukaemia (CLL) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/chronic-lymphocytic-leukaemia-cll/staging

  The symptoms you might feel include: […] stage A, the only symptom you are likely to have is enlarged lymph nodes […] stage B, you may feel tired and under the weather, or you may have no symptoms […] stage C, you have low levels of red blood cells (anaemia) and feel tired. You might have signs of abnormal blood clotting, such as nosebleeds, bruising or heavy periods. You may get repeated infections. You might also lose weight and have night sweats. […] Symptoms of CLL can include swollen glands, weight loss and infections that don’t get better. Many people with CLL don’t have any symptoms.

• #10 Chronic Lymphocytic Leukemia (CLL): Stages – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=chronic-lymphocytic-leukemia-cll-stages-34-BCLL05

  Stage 0. The blood has too many white blood cells called lymphocytes. This is called lymphocytosis. The other blood counts are close to normal, and there are no other symptoms of leukemia. The cancer is slow growing, and this stage is low risk. This means people tend to have longer survival rates and have no or few symptoms. […] Stage I. The blood has too many lymphocytes. The lymph nodes are larger than normal. Other organs are normal size, and the red blood cell and platelet counts are close to normal, too. This stage is medium risk. […] Stage II. The blood has too many lymphocytes. The spleen is swollen or enlarged. This is called splenomegaly. The liver may be swollen. This is called hepatomegaly. The lymph nodes may also be larger than normal. Red blood cell and platelet counts are close to normal. This stage is medium risk.

• #11 Chronic Lymphocytic Leukemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470433/

  Chronic lymphocytic leukemia is a chronic lymphoproliferative disorder characterized by monoclonal B cell proliferation. […] Chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) is an indolent malignancy characterized by increased production of mature but dysfunctional B lymphocytes. […] The most common abnormal physical examination findings are lymphadenopathy, which is seen in 50 to 90% of patients. […] These neoplastic B cells escape apoptosis and continue to divide over time within the lymph nodes. They then infiltrate the spleen and bone marrow, causing splenomegaly and hypercellular bone marrow (on bone marrow biopsy). […] Patients are more susceptible to autoimmune hemolytic anemia (positive Coombs test) and autoimmune thrombocytopenia. […] These B cells eventually spread throughout the body, causing systemic symptoms such as fever, night sweats, unintentional weight loss, fatigue, and early satiety.

• #12 Chronic Lymphocytic Leukemia With Variant Genetics – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK585059/

  Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in the Western world. It is characterized as a mature B-cell malignancy associated with B-cell clonal proliferation. […] Approximately 5 to 10% of patients present with one or more B symptoms, including fevers of 100.5 F (38 C) for two or more weeks without evidence of infection, night sweats without evidence of infections, extreme fatigue, or unintentional weight loss of 10 percent of body weight in the last six months. […] The physical examination can reveal lymphadenopathy in 50 to 90% of patients. Lymphadenopathy commonly affects cervical, supraclavicular, and axillary lymph node regions with enlarged lymph nodes that are round, non-tender, firm, and mobile. Organomegaly can occur with splenomegaly and hepatomegaly identified in 25 to 55% and 15 to 25% of patients, respectively.

• #13 What Is Chronic Lymphocytic Leukemia (CLL)?

  https://my.clevelandclinic.org/health/diseases/6210-chronic-lymphocytic-leukemia

  Chronic lymphocytic leukemia (CLL) is a type of blood cancer. It happens when healthy white blood cells (lymphocytes) in your bone marrow mutate, or change, into cancerous cells that multiply and crowd out healthy blood cells and platelets. […] You can have chronic lymphocytic leukemia without symptoms. It may take months to years before you notice CLL symptoms. Common symptoms include: […] Fatigue. CLL affects your red blood cells, causing anemia. Fatigue is a common anemia symptom. […] Fever. Fever is a sign of infection. CLL affects healthy white blood cells, increasing your risk of infections. […] Swollen lymph nodes in your neck, underarm, groin or stomach. […] Night sweats. […] Unexplained weight loss. […] Pain or a sense of fullness under your ribs. CLL may affect your liver or spleen. Cancerous white blood cells in your liver and/or spleen can make those organs grow.

• #14 Chronic Lymphocytic Leukemia | CLL | MedlinePlus

  https://medlineplus.gov/chroniclymphocyticleukemia.html

  In the beginning, CLL does not cause any symptoms. Later, you can have symptoms such as: […] Swollen lymph nodes – you may notice them as painless lumps in the neck, underarm, stomach, or groin […] Weakness or feeling tired […] Pain or a feeling of fullness below the ribs […] Fever and infection […] Easy bruising or bleeding […] Petechiae, which are tiny red dots under the skin. They are caused by bleeding. […] Weight loss for no known reason […] Drenching night sweats. […] In CLL, the bone marrow makes abnormal lymphocytes (a type of white blood cell). When the abnormal cells crowd out the healthy cells, it can lead to infection, anemia, and easy bleeding. The abnormal cells can also spread outside the blood to other parts of the body.

• #15 Chronic Lymphocytic Leukemia With Variant Genetics – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK585059/

  Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in the Western world. It is characterized as a mature B-cell malignancy associated with B-cell clonal proliferation. […] Approximately 5 to 10% of patients present with one or more B symptoms, including fevers of 100.5 F (38 C) for two or more weeks without evidence of infection, night sweats without evidence of infections, extreme fatigue, or unintentional weight loss of 10 percent of body weight in the last six months. […] The physical examination can reveal lymphadenopathy in 50 to 90% of patients. Lymphadenopathy commonly affects cervical, supraclavicular, and axillary lymph node regions with enlarged lymph nodes that are round, non-tender, firm, and mobile. Organomegaly can occur with splenomegaly and hepatomegaly identified in 25 to 55% and 15 to 25% of patients, respectively.

• #16 Symptoms of CLL | Blood Cancer UK

  https://bloodcancer.org.uk/understanding-blood-cancer/leukaemia/chronic-lymphocytic-leukaemia-cll/cll-symptoms-diagnosis/cll-symptoms/

  Many people with chronic lymphocytic leukaemia (CLL) are diagnosed after a routine blood test and havent noticed any symptoms. Others may have one or more symptoms such as feeling extremely tired, swollen glands, night sweats or lots of infections. […] Fatigue is a very common symptom at all stages of CLL, and many people will experience it at the point of diagnosis. Its a type of extreme tiredness that comes on quickly and can take time to go away. […] Other symptoms are more common in advanced CLL and are rare at diagnosis, when most people feel well. […] If you experience any of these symptoms at any stage of CLL, tell your GP or hospital team. It will help them decide whether its time to start treatment. […] getting tired or breathless more quickly […] swollen lymph nodes (glands), usually in your neck, armpits, groin, or under your collarbone

• #17 What Is Chronic Lymphocytic Leukemia (CLL)?

  https://my.clevelandclinic.org/health/diseases/6210-chronic-lymphocytic-leukemia

  Chronic lymphocytic leukemia (CLL) is a type of blood cancer. It happens when healthy white blood cells (lymphocytes) in your bone marrow mutate, or change, into cancerous cells that multiply and crowd out healthy blood cells and platelets. […] You can have chronic lymphocytic leukemia without symptoms. It may take months to years before you notice CLL symptoms. Common symptoms include: […] Fatigue. CLL affects your red blood cells, causing anemia. Fatigue is a common anemia symptom. […] Fever. Fever is a sign of infection. CLL affects healthy white blood cells, increasing your risk of infections. […] Swollen lymph nodes in your neck, underarm, groin or stomach. […] Night sweats. […] Unexplained weight loss. […] Pain or a sense of fullness under your ribs. CLL may affect your liver or spleen. Cancerous white blood cells in your liver and/or spleen can make those organs grow.

• #18 Signs and Symptoms of CLL | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/detection-diagnosis-staging/signs-symptoms.html

  A shortage of red blood cells (anemia) can lead to: Feeling very tired, Weakness, Shortness of breath. […] A shortage of normal white blood cells (leukopenia) increases the risk of infections. […] People with CLL may have very high white blood cell counts because of excess numbers of lymphocytes (lymphocytosis), but the leukemia cells dont fight infection the way normal white blood cells do. […] A shortage of blood platelets (thrombocytopenia) can lead to: Excess bruising, Bleeding, Frequent or severe nosebleeds, Bleeding gums. […] CLL is a cancer of B lymphocytes, which normally make antibodies that help fight infections. In some people, the CLL cells make abnormal antibodies that attack normal blood cells. This is known as autoimmunity. It can lead to low blood counts. […] The symptoms and signs above may be caused by CLL, but they can also be caused by other conditions. Still, if you have any of these problems, its important to see a doctor so the cause can be found and treated if needed.

• #19 CLL Basics – What is Chronic Lymphocytic Leukemia? | Sarah Cannon

  https://sarahcannon.com/for-patients/learn-about-cancer/blood-cancer/cll/

  Chronic lymphocytic leukemia (CLL) symptoms usually develop over time. Early in the course of the disease, CLL often has little effect on a person’s well-being. Some people with CLL do not have any symptoms. The disease may be suspected because of abnormal results from blood tests that were ordered either as part of an annual physical or a medical examination for an unrelated condition. An unexplained elevated white blood cell (lymphocyte) count is the most common finding that leads a doctor to consider a CLL diagnosis. […] People with CLL who do have symptoms may: Tire more easily, and/or feel short of breath during day-to-day physical activities, Lose weight because of decreased appetite and/or increased use of energy, Have lymph nodes and a spleen that may become enlarged as a result of an accumulation of CLL cells (leukemic lymphocytes), Have infections of the skin, lungs, kidneys or other sites that may occur as result of low immunoglobulin levels and decreased neutrophil counts.

• #20 Disease progression of chronic lymphocytic leukemia | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/chronic-lymphocytic-leukemia-cll/disease-progression

  Symptoms of the progression of CLL include: […] more than 10% weight loss in 6 months […] extreme fatigue […] fever for more than 2 weeks without any signs of infection […] night sweats for longer than 1 month […] an increasing number of CLL cells in the bone marrow that make the bone marrow not work properly, leading to anemia (lower numbers of healthy red blood cells) or thrombocytopenia (lower number of platelets in the blood) […] a spleen that is larger than normal and may be causing symptoms such as discomfort or a feeling of fullness […] more areas of enlarged lymph nodes in the body that cause discomfort […] an enlarged liver that causes discomfort […] the number of lymphocytes increases by more than 50% in 2 months or doubles in less than 6 months (rapid doubling time).

• #21 CLL Symptoms – CLL Society

  https://cllsociety.org/cll-sll-patient-education-toolkit/cll-symptoms/

  Examples of B symptoms include: […] Unexplained weight loss that is more than 10% of total body weight in the previous 6 months. […] Severe fatigue that makes it difficult to work or perform usual daily activities. […] Fevers higher than 100.4°F lasting for at least 2 weeks without any other signs of infection. […] Drenching night sweats (soaking the bed sheets) for more than a month without evidence of infection. […] […] Some symptoms tend to occur later in the course of the disease and are sometimes referred to as secondary symptoms. These may include: […] Repeat infections that are caused by low levels of healthy white blood cells. […] Red, flat, pinpoint spots under the skin called petechiae. […] Easy bleeding or excessive bruising that occurs when the cancerous CLL cells in the bone marrow crowd out the number of cells that are needed to help with blood clotting (called platelets). […] Shortness of breath or light-headedness that occurs when the cancerous CLL cells reduce the number of cells that are needed to carry oxygen to tissues (called red blood cells).

• #22 Chronic Lymphocytic Leukemia: Signs of Progression or Relapse

  https://www.webmd.com/cancer/lymphoma/ss/slideshow-cll-symptoms-progression-relapse

  Sweating at night could simply mean that your bedroom is too hot or your covers are too heavy. But waking up drenched in sweat with your sheets soaked through could be night sweats from CLL, especially if this symptom lasts longer than a month. […] Your spleen is an organ in your immune system that sits on the left side of your belly, just behind your ribs. It’s filled with infection-fighting white blood cells. When leukemia cells multiply inside the spleen, it swells up. […] CLL can change from a slow-growing or low-grade cancer to an aggressive and fast-growing or high-grade cancer. Bone pain is a sign that your cancer is growing more quickly. […] As cancer cells multiply in your bone marrow, they crowd out healthy red blood cells and platelets. An abnormal blood test would show that your lymphocytes increased by more than 50% in 2 months or doubled in less than 6 months.

• #23 What Are B Symptoms in CLL and Other Types of Leukemia? | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/what-are-b-symptoms-in-cll-and-other-types-of-leukemia

  B symptoms are a group of symptoms commonly associated with lymphomas, both Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). B symptoms can occur with CLL and other types of leukemia, as well as other blood cancers. […] B symptoms include: Fever Having a body temperature over 100.4 degrees Fahrenheit (38 degrees Celsius) for no apparent reason, Sweating a lot at night Sometimes drenching clothes or sheets, Significant, unintentional weight loss Dropping more than 10 percent of your body weight in the previous six months. […] B symptoms may be early symptoms of both lymphocytic leukemia and lymphomas. However, symptoms of chronic leukemia, such as CLL or chronic myeloid leukemia, may not show up until years after the disease starts, so B symptoms aren’t reliable indicators of cancer. […] Nonetheless, B symptoms sometimes indicate that it’s time to start targeted therapy. For example, the authors of a 2023 study wrote that people with CLL who had fever, drenching night sweats, and weight loss (B symptoms) should be offered treatment. […] If you’re having B symptoms that persist, it’s best to speak with your doctor or oncologist. They may do some blood tests to look for any changes in disease progression and decide whether your treatment plan needs to be adjusted.

• #24 Signs that CLL is Progressing – HealthTree for Chronic Lymphocytic Leukemia

  https://healthtree.org/cll/community/articles/cll-progressing

  An initial diagnosis of CLL may be surprising because symptoms may not be present. CLL is often a slow-growing cancer so treatment may be put on hold until it starts to progress. Once it advances to an intermediate or high-risk stage, your doctor will recommend treatment. […] Let Your Doctor Know if You Experience Any of These Symptoms: […] Weight loss – Unexplained loss of over 10% of body weight over the course of a 6-month period of time may indicate CLL is progressing […] Extreme tiredness – Extreme fatigue or shortness of breath while doing normal day-to-day activities should be a sign of concern. Fewer red blood cells and an increase in cancer cells can cause fatigue […] Fever and night sweats – Any unexplained fever over 100.4 degrees F (38 degrees C) should be reported. A high fever may cause severe night sweats

• #25 CLL Symptoms – CLL Society

  https://cllsociety.org/cll-sll-patient-education-toolkit/cll-symptoms/

  Examples of B symptoms include: […] Unexplained weight loss that is more than 10% of total body weight in the previous 6 months. […] Severe fatigue that makes it difficult to work or perform usual daily activities. […] Fevers higher than 100.4°F lasting for at least 2 weeks without any other signs of infection. […] Drenching night sweats (soaking the bed sheets) for more than a month without evidence of infection. […] […] Some symptoms tend to occur later in the course of the disease and are sometimes referred to as secondary symptoms. These may include: […] Repeat infections that are caused by low levels of healthy white blood cells. […] Red, flat, pinpoint spots under the skin called petechiae. […] Easy bleeding or excessive bruising that occurs when the cancerous CLL cells in the bone marrow crowd out the number of cells that are needed to help with blood clotting (called platelets). […] Shortness of breath or light-headedness that occurs when the cancerous CLL cells reduce the number of cells that are needed to carry oxygen to tissues (called red blood cells).

• #26 Symptoms of chronic lymphocytic leukaemia (CLL) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/chronic-lymphocytic-leukaemia-cll/symptoms

  Many people with chronic lymphocytic leukaemia (CLL) won’t have any symptoms at all. […] In CLL, symptoms tend to be mild at first and get worse slowly. Many symptoms are vague. You may feel as if you had the flu. […] Symptoms of CLL include: swollen lymph glands or tummy (abdominal) discomfort from an enlarged spleen, weight loss, infections that will not get better, feeling tired, anaemia, bleeding or bruising, bone pain or night sweats. […] In CLL, you can have swollen glands (lymph nodes). The swollen glands are most often in your neck or under your arms. You may also get an enlarged spleen. […] CLL itself uses up energy that your body would otherwise use or store. So you may lose weight, even if you eat normally. […] As the number of abnormal white blood cells rise, you may pick up infections more easily.

• #27 Chronic Lymphocytic Leukemia With Variant Genetics – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK585059/

  Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in the Western world. It is characterized as a mature B-cell malignancy associated with B-cell clonal proliferation. […] Approximately 5 to 10% of patients present with one or more B symptoms, including fevers of 100.5 F (38 C) for two or more weeks without evidence of infection, night sweats without evidence of infections, extreme fatigue, or unintentional weight loss of 10 percent of body weight in the last six months. […] The physical examination can reveal lymphadenopathy in 50 to 90% of patients. Lymphadenopathy commonly affects cervical, supraclavicular, and axillary lymph node regions with enlarged lymph nodes that are round, non-tender, firm, and mobile. Organomegaly can occur with splenomegaly and hepatomegaly identified in 25 to 55% and 15 to 25% of patients, respectively.

• #28 What Is Chronic Lymphocytic Leukemia (CLL)?

  https://my.clevelandclinic.org/health/diseases/6210-chronic-lymphocytic-leukemia

  Chronic lymphocytic leukemia (CLL) is a type of blood cancer. It happens when healthy white blood cells (lymphocytes) in your bone marrow mutate, or change, into cancerous cells that multiply and crowd out healthy blood cells and platelets. […] You can have chronic lymphocytic leukemia without symptoms. It may take months to years before you notice CLL symptoms. Common symptoms include: […] Fatigue. CLL affects your red blood cells, causing anemia. Fatigue is a common anemia symptom. […] Fever. Fever is a sign of infection. CLL affects healthy white blood cells, increasing your risk of infections. […] Swollen lymph nodes in your neck, underarm, groin or stomach. […] Night sweats. […] Unexplained weight loss. […] Pain or a sense of fullness under your ribs. CLL may affect your liver or spleen. Cancerous white blood cells in your liver and/or spleen can make those organs grow.

• #29 Chronic Lymphocytic Leukemia – Lymphoma Research Foundation

  https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/cll/

  Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are cancers that affect lymphocytes. […] Many patients with CLL/SLL do not have any obvious symptoms of the disease. Their doctors might detect the disease during routine blood tests and/or a physical examination. For others, the disease is detected when symptoms occur and the patient goes to the doctor because he or she is worried, uncomfortable, or does not feel well. CLL/SLL may cause different symptoms depending on the location of the tumor in the body. The symptoms of CLL/SLL include a tender, swollen abdomen and feeling full even after eating only a small amount. Other symptoms can include fatigue, shortness of breath, anemia, bruising easily, night sweats, weight loss, and frequent infections. However, many patients with CLL/SLL will live for years without symptoms.

• #30 What Is Chronic Lymphocytic Leukemia (CLL)?

  https://my.clevelandclinic.org/health/diseases/6210-chronic-lymphocytic-leukemia

  Chronic lymphocytic leukemia affects your red blood cells, white blood cells and platelets. Red blood cells carry oxygen throughout your body. White blood cells protect you from infection. Platelets help your blood to clot. Without healthy blood cells and platelets, you may develop the following complications: […] Frequent infections: You may have an increased risk of bacterial, fungal or viral infections because you dont have enough healthy white blood cells. […] Chronic lymphocytic leukemia (CLL) typically develops very slowly. You can live for a long time with CLL before you notice symptoms. When you do, healthcare providers have very effective treatments that put CLL into remission. Remission from CLL typically lasts for several years before the condition comes back. Even then, your provider may recommend different treatments that put CLL back into remission. CLL never goes away, but people can still live a long and full life with the disease.

• #31 Chronic lymphocytic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_lymphocytic_leukemia

  Patients with CLL have an increased risk of developing serious infections. Thus, they should be routinely monitored and promptly treated with antibiotics if an infection is present. In patients with significant signs or symptoms, treatment can involve chemotherapy, immunotherapy, or chemoimmunotherapy. The most appropriate treatment is based on the individual’s age, physical condition, and whether they have the del(17p) or TP53 mutation. […] About 25% of patients with CLL have very low levels of antibodies in their bloodstream (hypogammaglobulinemia) at diagnosis, with several more patients developing this throughout the course of their disease. This decrease in antibodies increases the patient’s risk of recurrent infections and other autoimmune complications, such as autoimmune hemolytic anemia and immune thrombocytopenia. Autoimmune hemolytic anemia occurs in about 5-10% of CLL patients, which is when one’s own immune system attacks its own red blood cells.

• #32 https://www.lls.org/leukemia/chronic-lymphocytic-leukemia/diagnosis

  https://www.lls.org/leukemia/chronic-lymphocytic-leukemia/diagnosis

  A person with CLL will have increased numbers of lymphocytes (a type of white blood cell). Low platelet counts and low red blood cell counts may also be present; these counts are usually only slightly decreased in the early stage of the illness. […] CLL cells do not make effective antibodies. CLL cells also interfere with the ability of the normal lymphocytes to make antibodies. As a result, people with CLL often have low levels of immunoglobulins, causing immune deficiency, which increases their risk of getting infections. […] About 80 percent of CLL patients who are tested with FISH have cytogenetic abnormalities in their leukemia cells. These cytogenetic abnormalities can help the doctor identify those people with CLL who are more likely to progress to the point of requiring therapy or those who may benefit most from use of certain types of therapy. […] CLL patients who have NOTCH1 gene mutations may have a faster progression of disease and a less favorable outcome. […] CLL patients who have this mutation may have a faster progression of disease, resistance to traditional therapy and a less favorable outcome.

• #33 Signs and Symptoms of CLL | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/detection-diagnosis-staging/signs-symptoms.html

  A shortage of red blood cells (anemia) can lead to: Feeling very tired, Weakness, Shortness of breath. […] A shortage of normal white blood cells (leukopenia) increases the risk of infections. […] People with CLL may have very high white blood cell counts because of excess numbers of lymphocytes (lymphocytosis), but the leukemia cells dont fight infection the way normal white blood cells do. […] A shortage of blood platelets (thrombocytopenia) can lead to: Excess bruising, Bleeding, Frequent or severe nosebleeds, Bleeding gums. […] CLL is a cancer of B lymphocytes, which normally make antibodies that help fight infections. In some people, the CLL cells make abnormal antibodies that attack normal blood cells. This is known as autoimmunity. It can lead to low blood counts. […] The symptoms and signs above may be caused by CLL, but they can also be caused by other conditions. Still, if you have any of these problems, its important to see a doctor so the cause can be found and treated if needed.

• #34 Chronic Lymphocytic Leukemia (CLL) |Medical Conditions | abbvieclinicaltrials.com

  https://www.abbvieclinicaltrials.com/health-conditions/chronic-lymphocytic-leukemia/

  Symptoms are often vague and can include the following: Weakness, Feeling tired, Weight loss, Fever, Night sweats, Enlarged Lymph nodes, Pain or a sense of fullness in the belly, caused by an enlarged spleen and/or liver. […] People with CLL have a higher risk of Infections. This is mainly because their Immune system is not working as well as it should. […] Anemia can cause tiredness, weakness, and shortness of breath. […] A shortage of blood platelets can lead to excess bruising, bleeding, severe nosebleeds and bleeding gums. […] Immune system: In some people with CLL, the Immune system Cells make abnormal antibodies that attack normal blood Cells. This is known as autoimmunity. It can lead to low blood counts.

• #35 Signs and Symptoms of CLL | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/detection-diagnosis-staging/signs-symptoms.html

  A shortage of red blood cells (anemia) can lead to: Feeling very tired, Weakness, Shortness of breath. […] A shortage of normal white blood cells (leukopenia) increases the risk of infections. […] People with CLL may have very high white blood cell counts because of excess numbers of lymphocytes (lymphocytosis), but the leukemia cells dont fight infection the way normal white blood cells do. […] A shortage of blood platelets (thrombocytopenia) can lead to: Excess bruising, Bleeding, Frequent or severe nosebleeds, Bleeding gums. […] CLL is a cancer of B lymphocytes, which normally make antibodies that help fight infections. In some people, the CLL cells make abnormal antibodies that attack normal blood cells. This is known as autoimmunity. It can lead to low blood counts. […] The symptoms and signs above may be caused by CLL, but they can also be caused by other conditions. Still, if you have any of these problems, its important to see a doctor so the cause can be found and treated if needed.

• #36 Chronic Lymphocytic Leukemia (CLL) |Medical Conditions | abbvieclinicaltrials.com

  https://www.abbvieclinicaltrials.com/health-conditions/chronic-lymphocytic-leukemia/

  Symptoms are often vague and can include the following: Weakness, Feeling tired, Weight loss, Fever, Night sweats, Enlarged Lymph nodes, Pain or a sense of fullness in the belly, caused by an enlarged spleen and/or liver. […] People with CLL have a higher risk of Infections. This is mainly because their Immune system is not working as well as it should. […] Anemia can cause tiredness, weakness, and shortness of breath. […] A shortage of blood platelets can lead to excess bruising, bleeding, severe nosebleeds and bleeding gums. […] Immune system: In some people with CLL, the Immune system Cells make abnormal antibodies that attack normal blood Cells. This is known as autoimmunity. It can lead to low blood counts.

• #37 Chronic lymphocytic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_lymphocytic_leukemia

  Patients with CLL have an increased risk of developing serious infections. Thus, they should be routinely monitored and promptly treated with antibiotics if an infection is present. In patients with significant signs or symptoms, treatment can involve chemotherapy, immunotherapy, or chemoimmunotherapy. The most appropriate treatment is based on the individual’s age, physical condition, and whether they have the del(17p) or TP53 mutation. […] About 25% of patients with CLL have very low levels of antibodies in their bloodstream (hypogammaglobulinemia) at diagnosis, with several more patients developing this throughout the course of their disease. This decrease in antibodies increases the patient’s risk of recurrent infections and other autoimmune complications, such as autoimmune hemolytic anemia and immune thrombocytopenia. Autoimmune hemolytic anemia occurs in about 5-10% of CLL patients, which is when one’s own immune system attacks its own red blood cells.

• #38 Chronic Lymphocytic Leukemia | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/chronic-lymphocytic-leukemia

  Many patients have no symptoms at the time of diagnosis, except for an elevated white blood cell count. Some patients notice fatigue, enlargement of lymph nodes or fullness in the abdomen due to an enlarged spleen. […] When CLL becomes more advanced and begins to replace normal bone marrow, low blood counts can cause: Anemia, due to low levels of red blood cells; Infections, due to low levels of white blood cells called neutrophils; Bleeding, due to low levels of platelets. […] CLL also increases a person’s risk of infection because of low production of antibodies (gamma globulins) that help fight bacteria. […] In 5 percent to 10 percent of cases, CLL causes the destruction of the patient’s own red blood cells and/or platelets through an „autoimmune” process. Destruction of platelets is called immune thrombocytopenic purpura (ITP), and destruction of red blood cells is called autoimmune hemolytic anemia (AHA).

• #39 Chronic Lymphocytic Leukemia (CLL): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/199313-overview

  The prognosis of patients with CLL varies widely at diagnosis. Some patients die rapidly, within 2-3 years of diagnosis, because of complications from CLL. In most patients CLL initially has a relatively benign course, but eventually enters a progressive, treatment-resistant phase. During this later phase, morbidity is considerable, both from the disease and from complications of therapy. With the advances in treatment of CLL in recent decades, prolonged survival is possible. However, treatment rarely cures CLL, and mortality rates in patients with CLL remain significantly higher than in the general population. […] Prognosis depends on the disease stage at diagnosis as well as the presence or absence of high-risk markers. Given the recent advancements in CLL treatment, the Rai and Binet staging systems do not provide sufficient utility to estimate prognosis. The most accurate prognostic score currently utilized by oncologists is the CLL International Prognostic Index (CLL-IPI), which relies on five independent prognostic factors.

• #40 CLL Basics – What is Chronic Lymphocytic Leukemia? | Sarah Cannon

  https://sarahcannon.com/for-patients/learn-about-cancer/blood-cancer/cll/

  Chronic lymphocytic leukemia (CLL) is a type of blood cancer that begins in the bone marrow and can progress either slowly or quickly depending on the form it takes. CLL is the most common type of leukemia in adults and can progress either slowly or rapidly, depending on the patient’s disease. […] CLL can be slow-growing and may not need immediate treatment, or it may grow at a faster rate, requiring treatment right away. The slower-growing form has an increased number of lymphocytes, but a normal or slightly below normal level of red cells, platelets and white cells in the blood and the disease can remain stable for years. When the CLL is more aggressive it leads to too many CLL cells in the marrow. This interferes with the production of normal blood cells, as the CLL cells are crowding out the healthy cells. As a result, the number of fully-functioning red cells and platelet levels then drop to lower-than-normal levels in the blood.

• #41 Chronic lymphocytic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_lymphocytic_leukemia

  Prognosis can be affected by the type of genetic mutation that the person with CLL has. Some examples of genetic mutations and their prognoses are: mutations in the IGHV region are associated with a median overall survival (OS) of more than 20-25 years, while no mutations in this region is associated with a median OS of 8-10 years; deletion of chromosome 13q is associated with a median OS of 17 years; and trisomy of chromosome 12, as well as deletion of chromosome 11q, is associated with a median OS of 9-11 years. While prognosis is highly variable and dependent on various factors including these mutations, the average 5-year relative survival is 86.1%.

• #42 Chronic lymphocytic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_lymphocytic_leukemia

  Prognosis can be affected by the type of genetic mutation that the person with CLL has. Some examples of genetic mutations and their prognoses are: mutations in the IGHV region are associated with a median overall survival (OS) of more than 20-25 years, while no mutations in this region is associated with a median OS of 8-10 years; deletion of chromosome 13q is associated with a median OS of 17 years; and trisomy of chromosome 12, as well as deletion of chromosome 11q, is associated with a median OS of 9-11 years. While prognosis is highly variable and dependent on various factors including these mutations, the average 5-year relative survival is 86.1%.

• #43 https://www.lls.org/leukemia/chronic-lymphocytic-leukemia/diagnosis

  https://www.lls.org/leukemia/chronic-lymphocytic-leukemia/diagnosis

  A person with CLL will have increased numbers of lymphocytes (a type of white blood cell). Low platelet counts and low red blood cell counts may also be present; these counts are usually only slightly decreased in the early stage of the illness. […] CLL cells do not make effective antibodies. CLL cells also interfere with the ability of the normal lymphocytes to make antibodies. As a result, people with CLL often have low levels of immunoglobulins, causing immune deficiency, which increases their risk of getting infections. […] About 80 percent of CLL patients who are tested with FISH have cytogenetic abnormalities in their leukemia cells. These cytogenetic abnormalities can help the doctor identify those people with CLL who are more likely to progress to the point of requiring therapy or those who may benefit most from use of certain types of therapy. […] CLL patients who have NOTCH1 gene mutations may have a faster progression of disease and a less favorable outcome. […] CLL patients who have this mutation may have a faster progression of disease, resistance to traditional therapy and a less favorable outcome.

• #44 Chronic Lymphocytic Leukemia (CLL) – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/chronic-lymphocytic-leukemia-cll

  Symptoms that prompt treatment in patients with CLL include constitutional symptoms (fever, night sweats, extreme fatigue, weight loss), significant hepatomegaly, splenomegaly, or lymphadenopathy, recurrent infections, and symptomatic anemia and/or thrombocytopenia. […] The natural history of chronic lymphocytic leukemia is highly variable. Survival ranges from about 2 to 20 years, with a median of about 10 years. Patients presenting as Rai stage 0 to II may survive for 5 to 20 years without treatment. […] Lymphocyte doubling time is the number of months it takes the absolute lymphocyte count to double. Untreated patients with a lymphocyte doubling time 12 months have a more aggressive clinical course.

• #45 Disease progression of chronic lymphocytic leukemia | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/chronic-lymphocytic-leukemia-cll/disease-progression

  Symptoms of the progression of CLL include: […] more than 10% weight loss in 6 months […] extreme fatigue […] fever for more than 2 weeks without any signs of infection […] night sweats for longer than 1 month […] an increasing number of CLL cells in the bone marrow that make the bone marrow not work properly, leading to anemia (lower numbers of healthy red blood cells) or thrombocytopenia (lower number of platelets in the blood) […] a spleen that is larger than normal and may be causing symptoms such as discomfort or a feeling of fullness […] more areas of enlarged lymph nodes in the body that cause discomfort […] an enlarged liver that causes discomfort […] the number of lymphocytes increases by more than 50% in 2 months or doubles in less than 6 months (rapid doubling time).

• #46 Signs that CLL is Progressing – HealthTree for Chronic Lymphocytic Leukemia

  https://healthtree.org/cll/community/articles/cll-progressing

  Frequent infections – CLL causes a weakened immune system because there aren’t enough white blood cells to fight infections. If you’re getting sick often, contact your CLL specialist […] Abnormal lab tests – Low numbers of red blood cells or platelets are a sign of disease progression. Lymphocytes should also be monitored closely. If they have increased by more than 50 percent in 2 months or doubled in 6 months, it may also signal disease progression […] Enlarged spleen – The spleen is responsible for filtering blood. When abnormal cells build up in the blood, the spleen becomes enlarged. Patients may feel abdominal discomfort or feel like they have a full stomach […] Swollen lymph nodes – Lymph nodes are mainly concentrated in the neck, groin, and armpits. Growing numbers of CLL cells in the lymph nodes will cause them to swell. Patients may feel a lump under the skin in those areas. […] Once you have been diagnosed with CLL, keep all scheduled check-ups and follow-up with your doctor regularly. If any signs of progression occur, contact your CLL specialist immediately.

• #47 Staging chronic lymphocytic leukaemia (CLL) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/chronic-lymphocytic-leukaemia-cll/staging

  The symptoms you might feel include: […] stage A, the only symptom you are likely to have is enlarged lymph nodes […] stage B, you may feel tired and under the weather, or you may have no symptoms […] stage C, you have low levels of red blood cells (anaemia) and feel tired. You might have signs of abnormal blood clotting, such as nosebleeds, bruising or heavy periods. You may get repeated infections. You might also lose weight and have night sweats. […] Symptoms of CLL can include swollen glands, weight loss and infections that don’t get better. Many people with CLL don’t have any symptoms.

• #48 Chronic Lymphocytic Leukemia (CLL): Stages – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=chronic-lymphocytic-leukemia-cll-stages-34-BCLL05

  Stage 0. The blood has too many white blood cells called lymphocytes. This is called lymphocytosis. The other blood counts are close to normal, and there are no other symptoms of leukemia. The cancer is slow growing, and this stage is low risk. This means people tend to have longer survival rates and have no or few symptoms. […] Stage I. The blood has too many lymphocytes. The lymph nodes are larger than normal. Other organs are normal size, and the red blood cell and platelet counts are close to normal, too. This stage is medium risk. […] Stage II. The blood has too many lymphocytes. The spleen is swollen or enlarged. This is called splenomegaly. The liver may be swollen. This is called hepatomegaly. The lymph nodes may also be larger than normal. Red blood cell and platelet counts are close to normal. This stage is medium risk.

• #49 Staging chronic lymphocytic leukaemia (CLL) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/chronic-lymphocytic-leukaemia-cll/staging

  The symptoms you might feel include: […] stage A, the only symptom you are likely to have is enlarged lymph nodes […] stage B, you may feel tired and under the weather, or you may have no symptoms […] stage C, you have low levels of red blood cells (anaemia) and feel tired. You might have signs of abnormal blood clotting, such as nosebleeds, bruising or heavy periods. You may get repeated infections. You might also lose weight and have night sweats. […] Symptoms of CLL can include swollen glands, weight loss and infections that don’t get better. Many people with CLL don’t have any symptoms.

• #50 Chronic Lymphocytic Leukemia (CLL): Stages – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=chronic-lymphocytic-leukemia-cll-stages-34-BCLL05

  Stage 0. The blood has too many white blood cells called lymphocytes. This is called lymphocytosis. The other blood counts are close to normal, and there are no other symptoms of leukemia. The cancer is slow growing, and this stage is low risk. This means people tend to have longer survival rates and have no or few symptoms. […] Stage I. The blood has too many lymphocytes. The lymph nodes are larger than normal. Other organs are normal size, and the red blood cell and platelet counts are close to normal, too. This stage is medium risk. […] Stage II. The blood has too many lymphocytes. The spleen is swollen or enlarged. This is called splenomegaly. The liver may be swollen. This is called hepatomegaly. The lymph nodes may also be larger than normal. Red blood cell and platelet counts are close to normal. This stage is medium risk.

• #51 CLL Stages: What Living With Stages 0-4 Is Like | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/stages-of-chronic-lymphocytic-leukemia

  You may experience different symptoms depending on the stage of CLL you’re living with. […] People in stage 0 may have no symptoms of leukemia. Lymphocytosis is usually detected on routine blood tests. Any symptoms experienced are very few and usually don’t interfere with daily life. One MyLeukemiaTeam member with stage 0 CLL explained, The only symptom I have so far is that I tire a little quicker than I used to. […] Symptoms are still minimal at stage 1. You may notice enlarged lymph nodes but otherwise feel close to normal. You may experience more fatigue and begin to have night sweats. […] In stage 2 CLL, there is lymphocytosis, and the spleen is enlarged. The liver and lymph nodes may or may not be enlarged, and blood test results show that red blood cell and platelet counts are near normal. An enlarged spleen or liver could cause some abdominal pain.

• #52 Chronic Lymphocytic Leukemia (CLL): Stages – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=chronic-lymphocytic-leukemia-cll-stages-34-BCLL05

  Stage 0. The blood has too many white blood cells called lymphocytes. This is called lymphocytosis. The other blood counts are close to normal, and there are no other symptoms of leukemia. The cancer is slow growing, and this stage is low risk. This means people tend to have longer survival rates and have no or few symptoms. […] Stage I. The blood has too many lymphocytes. The lymph nodes are larger than normal. Other organs are normal size, and the red blood cell and platelet counts are close to normal, too. This stage is medium risk. […] Stage II. The blood has too many lymphocytes. The spleen is swollen or enlarged. This is called splenomegaly. The liver may be swollen. This is called hepatomegaly. The lymph nodes may also be larger than normal. Red blood cell and platelet counts are close to normal. This stage is medium risk.

• #53 Chronic Lymphocytic Leukemia (CLL): Stages – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=chronic-lymphocytic-leukemia-cll-stages-34-BCLL05

  Stage III. The blood has too many lymphocytes. The blood also has too few red blood cells. This is called anemia. The lymph nodes, liver, or spleen may be larger than normal. Platelet counts are close to normal. This stage is high risk. […] Stage IV. The blood has too many lymphocytes. It also has too few platelets. This is called thrombocytopenia. The lymph nodes, liver, or spleen may be larger than normal. The blood may have too few red blood cells. This stage is high risk.

• #54 CLL Stages: What Living With Stages 0-4 Is Like | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/stages-of-chronic-lymphocytic-leukemia

  You may experience different symptoms depending on the stage of CLL you’re living with. […] People in stage 0 may have no symptoms of leukemia. Lymphocytosis is usually detected on routine blood tests. Any symptoms experienced are very few and usually don’t interfere with daily life. One MyLeukemiaTeam member with stage 0 CLL explained, The only symptom I have so far is that I tire a little quicker than I used to. […] Symptoms are still minimal at stage 1. You may notice enlarged lymph nodes but otherwise feel close to normal. You may experience more fatigue and begin to have night sweats. […] In stage 2 CLL, there is lymphocytosis, and the spleen is enlarged. The liver and lymph nodes may or may not be enlarged, and blood test results show that red blood cell and platelet counts are near normal. An enlarged spleen or liver could cause some abdominal pain.

• #55 Staging chronic lymphocytic leukaemia (CLL) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/chronic-lymphocytic-leukaemia-cll/staging

  The symptoms you might feel include: […] stage A, the only symptom you are likely to have is enlarged lymph nodes […] stage B, you may feel tired and under the weather, or you may have no symptoms […] stage C, you have low levels of red blood cells (anaemia) and feel tired. You might have signs of abnormal blood clotting, such as nosebleeds, bruising or heavy periods. You may get repeated infections. You might also lose weight and have night sweats. […] Symptoms of CLL can include swollen glands, weight loss and infections that don’t get better. Many people with CLL don’t have any symptoms.

• #56 Chronic Lymphocytic Leukemia (CLL): Stages – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=chronic-lymphocytic-leukemia-cll-stages-34-BCLL05

  Stage III. The blood has too many lymphocytes. The blood also has too few red blood cells. This is called anemia. The lymph nodes, liver, or spleen may be larger than normal. Platelet counts are close to normal. This stage is high risk. […] Stage IV. The blood has too many lymphocytes. It also has too few platelets. This is called thrombocytopenia. The lymph nodes, liver, or spleen may be larger than normal. The blood may have too few red blood cells. This stage is high risk.

• #57 Staging chronic lymphocytic leukaemia (CLL) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/chronic-lymphocytic-leukaemia-cll/staging

  The symptoms you might feel include: […] stage A, the only symptom you are likely to have is enlarged lymph nodes […] stage B, you may feel tired and under the weather, or you may have no symptoms […] stage C, you have low levels of red blood cells (anaemia) and feel tired. You might have signs of abnormal blood clotting, such as nosebleeds, bruising or heavy periods. You may get repeated infections. You might also lose weight and have night sweats. […] Symptoms of CLL can include swollen glands, weight loss and infections that don’t get better. Many people with CLL don’t have any symptoms.

• #58 CLL Stages: What Living With Stages 0-4 Is Like | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/stages-of-chronic-lymphocytic-leukemia

  In stage 3, you might develop symptoms of anemia, which can make you a lot more tired than you were before. One MyLeukemiaTeam member wrote, I have anemia along with the CLL, so I get tired easy. […] At this point, you’re likely to experience symptoms of anemia. If your organs get large enough, you may feel overly full. […] Due to the low platelet count, you may notice symptoms like: Bruising or bleeding easily, Nosebleeds, Bleeding longer than usual if skin is cut, Pinkish or reddish urine. […] But by stage 4, you’re more likely to experience symptoms like shortness of breath, low-grade fever, and weight loss, which can become worrying. One member voiced, I’ve noticed some weight loss. Needless to say, I’m scared.

• #59 CLL Stages: What Living With Stages 0-4 Is Like | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/stages-of-chronic-lymphocytic-leukemia

  In stage 3, you might develop symptoms of anemia, which can make you a lot more tired than you were before. One MyLeukemiaTeam member wrote, I have anemia along with the CLL, so I get tired easy. […] At this point, you’re likely to experience symptoms of anemia. If your organs get large enough, you may feel overly full. […] Due to the low platelet count, you may notice symptoms like: Bruising or bleeding easily, Nosebleeds, Bleeding longer than usual if skin is cut, Pinkish or reddish urine. […] But by stage 4, you’re more likely to experience symptoms like shortness of breath, low-grade fever, and weight loss, which can become worrying. One member voiced, I’ve noticed some weight loss. Needless to say, I’m scared.

• #60 CLL Stages: What Living With Stages 0-4 Is Like | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/stages-of-chronic-lymphocytic-leukemia

  In stage 3, you might develop symptoms of anemia, which can make you a lot more tired than you were before. One MyLeukemiaTeam member wrote, I have anemia along with the CLL, so I get tired easy. […] At this point, you’re likely to experience symptoms of anemia. If your organs get large enough, you may feel overly full. […] Due to the low platelet count, you may notice symptoms like: Bruising or bleeding easily, Nosebleeds, Bleeding longer than usual if skin is cut, Pinkish or reddish urine. […] But by stage 4, you’re more likely to experience symptoms like shortness of breath, low-grade fever, and weight loss, which can become worrying. One member voiced, I’ve noticed some weight loss. Needless to say, I’m scared.

• #61 Chronic lymphocytic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_lymphocytic_leukemia

  A more serious complication called Richter’s transformation (RT) occurs in 2-10% of patients with CLL. This is a process in which the original CLL cells convert to a far more aggressive disease that has the biology and histopathology of diffuse large B cell lymphoma or less commonly Hodgkin’s lymphoma. These patients typically present with a sudden clinical deterioration that can be characterized by unexplained fevers or weight loss, asymmetric and rapid growth of lymph nodes, and/or a significant drop in the number of white blood cells, red blood cells, or platelets. […] The diagnosis of CLL is based on the demonstration of an abnormal population of B lymphocytes in the blood, bone marrow, or tissues that display an unusual but characteristic pattern of molecules on the cell surface. CLL is usually first suspected by a diagnosis of lymphocytosis, an increase in a type of white blood cell, on a complete blood count test. This frequently is an incidental finding on a routine physician visit. Most often the lymphocyte count is greater than 5000 cells per microliter (L) of blood but can be much higher.

• #62 Chronic lymphocytic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_lymphocytic_leukemia

  A more serious complication called Richter’s transformation (RT) occurs in 2-10% of patients with CLL. This is a process in which the original CLL cells convert to a far more aggressive disease that has the biology and histopathology of diffuse large B cell lymphoma or less commonly Hodgkin’s lymphoma. These patients typically present with a sudden clinical deterioration that can be characterized by unexplained fevers or weight loss, asymmetric and rapid growth of lymph nodes, and/or a significant drop in the number of white blood cells, red blood cells, or platelets. […] The diagnosis of CLL is based on the demonstration of an abnormal population of B lymphocytes in the blood, bone marrow, or tissues that display an unusual but characteristic pattern of molecules on the cell surface. CLL is usually first suspected by a diagnosis of lymphocytosis, an increase in a type of white blood cell, on a complete blood count test. This frequently is an incidental finding on a routine physician visit. Most often the lymphocyte count is greater than 5000 cells per microliter (L) of blood but can be much higher.

• #63 Chronic Lymphocytic Leukemia | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/chronic-lymphocytic-leukemia

  Most patients with early-stage chronic lymphocytic leukemia do not need any treatment when the disease is first diagnosed. These patients will live 10 to 15 years on average, and early treatment offers no advantage. […] Treatment should start when the patient either has an advanced form of the disease or has an intermediate stage with significant symptoms, very enlarged lymph nodes or a rapid increase in the lymphocyte count (doubling in less than 12 months). […] In 5 percent to 10 percent of cases, CLL can transform to an aggressive lymphoma. This is called Richter’s syndrome, and it requires lymphoma treatment.

• #64 Chronic lymphocytic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_lymphocytic_leukemia

  A more serious complication called Richter’s transformation (RT) occurs in 2-10% of patients with CLL. This is a process in which the original CLL cells convert to a far more aggressive disease that has the biology and histopathology of diffuse large B cell lymphoma or less commonly Hodgkin’s lymphoma. These patients typically present with a sudden clinical deterioration that can be characterized by unexplained fevers or weight loss, asymmetric and rapid growth of lymph nodes, and/or a significant drop in the number of white blood cells, red blood cells, or platelets. […] The diagnosis of CLL is based on the demonstration of an abnormal population of B lymphocytes in the blood, bone marrow, or tissues that display an unusual but characteristic pattern of molecules on the cell surface. CLL is usually first suspected by a diagnosis of lymphocytosis, an increase in a type of white blood cell, on a complete blood count test. This frequently is an incidental finding on a routine physician visit. Most often the lymphocyte count is greater than 5000 cells per microliter (L) of blood but can be much higher.

• #65 Chronic Lymphocytic Leukemia in Dogs | VCA Animal Hospitals

  https://vcahospitals.com/know-your-pet/chronic-lymphocytic-leukemia-in-dogs

  Chronic lymphocytic leukemia (CLL) is a slow-progressing, uncommon cancer of lymphocytes (a type of white blood cell). […] Clinical signs are subtle and can include lethargy, reduced appetite, weight loss, fever, and increased drinking and urination. Often, there are no signs, and the disease is detected on a routine blood test. On physical examination, your veterinarian may detect mildly enlarged lymph nodes or an enlarged liver or spleen. […] Rarely, patients with CLL will develop aggressive lymphoma called Richters syndrome. In these patients, severe lymph node enlargement, coughing, vomiting, weight loss, and neurologic signs can develop. […] Anemia (low red blood cell count) may be seen when CLL is initially diagnosed and will worsen as the disease progresses. […] CLL generally progresses very slowly, and treatment is often only initiated after clinical signs are observed or when high lymphocyte numbers are detected on blood work. The response to treatment is usually quite good, although remission is rare. The average survival time after treatment is initiated has been shown to be one to three years. Dogs with the T-cell type have a better prognosis than dogs with the atypical type of CLL. […] Unfortunately, dogs diagnosed with Richters syndrome have a poor prognosis for survival.

• #66 Chronic Lymphocytic Leukemia (CLL) – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/chronic-lymphocytic-leukemia-cll

  Symptoms that prompt treatment in patients with CLL include constitutional symptoms (fever, night sweats, extreme fatigue, weight loss), significant hepatomegaly, splenomegaly, or lymphadenopathy, recurrent infections, and symptomatic anemia and/or thrombocytopenia. […] The natural history of chronic lymphocytic leukemia is highly variable. Survival ranges from about 2 to 20 years, with a median of about 10 years. Patients presenting as Rai stage 0 to II may survive for 5 to 20 years without treatment. […] Lymphocyte doubling time is the number of months it takes the absolute lymphocyte count to double. Untreated patients with a lymphocyte doubling time 12 months have a more aggressive clinical course.

• #67 Chronic Lymphocytic Leukemia (CLL) – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/chronic-lymphocytic-leukemia-cll

  Symptoms that prompt treatment in patients with CLL include constitutional symptoms (fever, night sweats, extreme fatigue, weight loss), significant hepatomegaly, splenomegaly, or lymphadenopathy, recurrent infections, and symptomatic anemia and/or thrombocytopenia. […] The natural history of chronic lymphocytic leukemia is highly variable. Survival ranges from about 2 to 20 years, with a median of about 10 years. Patients presenting as Rai stage 0 to II may survive for 5 to 20 years without treatment. […] Lymphocyte doubling time is the number of months it takes the absolute lymphocyte count to double. Untreated patients with a lymphocyte doubling time 12 months have a more aggressive clinical course.

• #68 Chronic lymphocytic leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-lymphocytic-leukemia/diagnosis-treatment/drc-20352433

  Chronic lymphocytic leukemia is typically a slow-growing cancer that may not require treatment. […] If your chronic lymphocytic leukemia doesn’t cause symptoms and doesn’t show signs of getting worse, you may not need treatment right away. Studies have shown that early treatment doesn’t extend lives for people with early-stage chronic lymphocytic leukemia. […] Your doctor uses the information about your cancer to determine the stage of your chronic lymphocytic leukemia. The stage tells your doctor how aggressive your cancer is and how likely it is to get worse quickly.

• #69 Chronic Lymphocytic Leukemia | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/chronic-lymphocytic-leukemia

  Most patients with early-stage chronic lymphocytic leukemia do not need any treatment when the disease is first diagnosed. These patients will live 10 to 15 years on average, and early treatment offers no advantage. […] Treatment should start when the patient either has an advanced form of the disease or has an intermediate stage with significant symptoms, very enlarged lymph nodes or a rapid increase in the lymphocyte count (doubling in less than 12 months). […] In 5 percent to 10 percent of cases, CLL can transform to an aggressive lymphoma. This is called Richter’s syndrome, and it requires lymphoma treatment.

• #70 Living With Chronic Lymphocytic Leukemia Since 2006 | AACR Cancer Progress Report 2014

  https://cancerprogressreport.aacr.org/report/survivor-journeys/cpr14-survivors-rampe/

  I was diagnosed with chronic lymphocytic leukemia (CLL) in 2006. CLL usually progresses slowly, so there was a period of watch and wait before I needed treatment. […] I didn’t have any symptoms except for the elevated white blood cell counts, so we did watch and wait for 7.5 years. […] During 2013, however, I got progressively more anemic as my blood cell counts dropped, and so did my platelet numbers. That’s called thrombocytopenia, and it meant that the CLL was impacting my bone marrow. I also started to get some swelling in the lymph nodes around my jaw and some swelling in my spleen. I was getting very tired just going up a couple of flights of stairs left me out of breath. In December, the anemia and the thrombocytopenia were bad enough that it was time to pull the trigger and start some form of treatment.

• #71 Recognizing When It Is Time to Treat – CLL Society

  https://cllsociety.org/cll-sll-patient-education-toolkit/recognizing-when-it-is-time-to-treat/

  Most people who have been diagnosed with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) have no symptoms initially and are usually advised that no treatment is necessary upon diagnosis. Since the disease is a chronic, slow-growing cancer, many have no symptoms and experience little to no change in their health for many years. […] Worsening symptoms of the disease develop slowly over time, so it is more important to look at trends versus any one lab result or symptom. It is critical to be aware of the signs and symptoms that may indicate there is a need to begin treatment. The decision of when to start treatment can be complex and varies from person to person. […] Most experts agree that treatment should begin when the disease begins to cause symptoms that interfere with daily life. Treatment will often be started when a person develops certain symptoms or when there are other signs that the cancer is worsening. These symptoms may include:

• #72 Recognizing When It Is Time to Treat – CLL Society

  https://cllsociety.org/cll-sll-patient-education-toolkit/recognizing-when-it-is-time-to-treat/

  Unexplained weight loss of more than 10% of total body weight in the previous 6 months. […] Severe fatigue that makes it difficult to work or perform usual daily activities. […] Fevers higher than 100.4°F lasting for at least 2 weeks without any other signs of infection. […] Drenching night sweats (soaking the bed sheets) for more than a month without evidence of infection. […] Abnormally low blood cell count values can occur because of an overgrowth of the cancerous cells in the bone marrow that crowd out the number of healthy cells. […] The spleen is located on the upper left side of the abdomen. When it becomes enlarged it can cause a person to feel full or bloated. […] These lumps that are often first felt in the neck or throat area can be painless at first. But they can also grow to become very enlarged and painful, which can mean it is time to begin a new treatment.

• #73 Chronic Lymphocytic Leukemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470433/

  Symptoms such as severe fatigue interfering with daily activities, B-symptoms, recurrent infections, or increased tumor burden indicate early treatment. […] Rapidly progressing disease such as an absolute lymphocyte count doubling time of fewer than 12 months is also an indication for early treatment.

• #74 Chronic Lymphocytic Leukemia (CLL) – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/chronic-lymphocytic-leukemia-cll

  Symptoms that prompt treatment in patients with CLL include constitutional symptoms (fever, night sweats, extreme fatigue, weight loss), significant hepatomegaly, splenomegaly, or lymphadenopathy, recurrent infections, and symptomatic anemia and/or thrombocytopenia. […] The natural history of chronic lymphocytic leukemia is highly variable. Survival ranges from about 2 to 20 years, with a median of about 10 years. Patients presenting as Rai stage 0 to II may survive for 5 to 20 years without treatment. […] Lymphocyte doubling time is the number of months it takes the absolute lymphocyte count to double. Untreated patients with a lymphocyte doubling time 12 months have a more aggressive clinical course.

• #75 Recognizing When It Is Time to Treat – CLL Society

  https://cllsociety.org/cll-sll-patient-education-toolkit/recognizing-when-it-is-time-to-treat/

  Unexplained weight loss of more than 10% of total body weight in the previous 6 months. […] Severe fatigue that makes it difficult to work or perform usual daily activities. […] Fevers higher than 100.4°F lasting for at least 2 weeks without any other signs of infection. […] Drenching night sweats (soaking the bed sheets) for more than a month without evidence of infection. […] Abnormally low blood cell count values can occur because of an overgrowth of the cancerous cells in the bone marrow that crowd out the number of healthy cells. […] The spleen is located on the upper left side of the abdomen. When it becomes enlarged it can cause a person to feel full or bloated. […] These lumps that are often first felt in the neck or throat area can be painless at first. But they can also grow to become very enlarged and painful, which can mean it is time to begin a new treatment.

• #76 Recognizing When It Is Time to Treat – CLL Society

  https://cllsociety.org/cll-sll-patient-education-toolkit/recognizing-when-it-is-time-to-treat/

  Repeat or prolonged infections that are caused by low levels of healthy white blood cells. […] Autoimmune cytopenias that can develop include Autoimmune Hemolytic Anemia (AIHA) or Immune Thrombocytopenic Purpura (ITP). Treating the underlying CLL or SLL will sometimes help control these conditions when they have not responded well to steroids or other standard therapy.

• #77 Living With Chronic Lymphocytic Leukemia Since 2006 | AACR Cancer Progress Report 2014

  https://cancerprogressreport.aacr.org/report/survivor-journeys/cpr14-survivors-rampe/

  I was diagnosed with chronic lymphocytic leukemia (CLL) in 2006. CLL usually progresses slowly, so there was a period of watch and wait before I needed treatment. […] I didn’t have any symptoms except for the elevated white blood cell counts, so we did watch and wait for 7.5 years. […] During 2013, however, I got progressively more anemic as my blood cell counts dropped, and so did my platelet numbers. That’s called thrombocytopenia, and it meant that the CLL was impacting my bone marrow. I also started to get some swelling in the lymph nodes around my jaw and some swelling in my spleen. I was getting very tired just going up a couple of flights of stairs left me out of breath. In December, the anemia and the thrombocytopenia were bad enough that it was time to pull the trigger and start some form of treatment.

• #78 Chronic Lymphocytic Leukemia (CLL): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/199313-overview

  The prognosis of patients with CLL varies widely at diagnosis. Some patients die rapidly, within 2-3 years of diagnosis, because of complications from CLL. In most patients CLL initially has a relatively benign course, but eventually enters a progressive, treatment-resistant phase. During this later phase, morbidity is considerable, both from the disease and from complications of therapy. With the advances in treatment of CLL in recent decades, prolonged survival is possible. However, treatment rarely cures CLL, and mortality rates in patients with CLL remain significantly higher than in the general population. […] Prognosis depends on the disease stage at diagnosis as well as the presence or absence of high-risk markers. Given the recent advancements in CLL treatment, the Rai and Binet staging systems do not provide sufficient utility to estimate prognosis. The most accurate prognostic score currently utilized by oncologists is the CLL International Prognostic Index (CLL-IPI), which relies on five independent prognostic factors.

• #79 Chronic lymphocytic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_lymphocytic_leukemia

  Prognosis can be affected by the type of genetic mutation that the person with CLL has. Some examples of genetic mutations and their prognoses are: mutations in the IGHV region are associated with a median overall survival (OS) of more than 20-25 years, while no mutations in this region is associated with a median OS of 8-10 years; deletion of chromosome 13q is associated with a median OS of 17 years; and trisomy of chromosome 12, as well as deletion of chromosome 11q, is associated with a median OS of 9-11 years. While prognosis is highly variable and dependent on various factors including these mutations, the average 5-year relative survival is 86.1%.

• #80 What Is Chronic Lymphocytic Leukemia (CLL)?

  https://my.clevelandclinic.org/health/diseases/6210-chronic-lymphocytic-leukemia

  Chronic lymphocytic leukemia affects your red blood cells, white blood cells and platelets. Red blood cells carry oxygen throughout your body. White blood cells protect you from infection. Platelets help your blood to clot. Without healthy blood cells and platelets, you may develop the following complications: […] Frequent infections: You may have an increased risk of bacterial, fungal or viral infections because you dont have enough healthy white blood cells. […] Chronic lymphocytic leukemia (CLL) typically develops very slowly. You can live for a long time with CLL before you notice symptoms. When you do, healthcare providers have very effective treatments that put CLL into remission. Remission from CLL typically lasts for several years before the condition comes back. Even then, your provider may recommend different treatments that put CLL back into remission. CLL never goes away, but people can still live a long and full life with the disease.

• #81 Living With Chronic Lymphocytic Leukemia Since 2006 | AACR Cancer Progress Report 2014

  https://cancerprogressreport.aacr.org/report/survivor-journeys/cpr14-survivors-rampe/

  Now I feel great. All my blood cell counts have returned to normal, except that I have low numbers of lymphocytes, but that’s the whole idea behind the treatment. My hemoglobin, platelets, neutrophils, and everything else is absolutely fine. […] None of these are curative, but they all seem very effective and I think these new treatments are going to have a significant effect on the natural course of the disease.

• #82 Chronic Lymphocytic Leukemia: Slow-Appearing Symptoms

  https://www.verywellhealth.com/chronic-lymphocytic-leukemia-7551732

  People with slow-growing low-risk CLL will not need treatment right away. Research has shown that treating this cancer early does not help people live longer. […] Most people live with CLL for many years. About one-third will live out their lives and die from other causes without needing treatment. The rest will need treatment eventually, sometimes for years. […] Chronic lymphocytic leukemia is a type of blood cancer. It affects the bone marrow and causes an increase in abnormal lymphocytic white blood cells. It is most common in adults around age 70 and progresses slowly. […] Symptoms of CLL can take a long time to appear. Its often discovered during tests for other reasons. Healthcare providers use blood, bone marrow, and imaging tests to diagnose CLL.

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