Home Types of cancer Chronic Lymphocytic Leukaemia

Chronic Lymphocytic Leukaemia

Chronic lymphocytic leukaemia is a type of blood cancer which develops when the body produces too many abnormal white blood cells, known as lymphocytes.

Quick facts about chronic lymphocytic leukaemiaQuick facts about chronic lymphocytic leukaemia

Chronic lymphocytic leukaemia (CLL) starts when the bone marrow produces partly-mature white blood cells that grow and spread abnormally
The white blood cells that CLL affects are called lymphocytes. They move through a large network of tissues and organs called the lymphatic system and impact areas such as the lymph nodes, spleen and liver. Normal lymphocytes mature into B-cells and T-cells, which fight infection
Chronic leukaemia develops slowly and may take months or years for symptoms to start showing. Because of this, around 30 to 50% of people diagnosed with CLL never require treatment
CLL accounts for 12.6% of diagnosed blood cancers
40% of all new CLL cases in the UK are diagnosed in people aged 75 years or over
Over 4,720 people are diagnosed with CLL in the UK every year.

Types of chronic lymphocytic leukaemiaTypes of chronic lymphocytic leukaemia

CLL typically grows slowly, however sometimes CLL can be faster growing. CLL involves a subset of lymphocytes called mature B cells.

Cancer treatment therapist caring for patient.

CLL

When only the blood and bone marrow is involved, it is known as CLL.

Cancer treatment therapist comforting a cancer patient.

SLL

Some patients may only have lymph node and liver or spleen involvement, this is termed Small Lymphocytic Lymphoma (SLL).

Most patients have a combination of both, which is known as CLL/SLL.

Signs and symptoms of chronic lymphocytic leukaemiaSigns and symptoms of chronic lymphocytic leukaemia

As signs and symptoms for CLL can be similar to other common conditions, it’s important to see your GP or healthcare professional if you experience any of the symptoms below. In many cases, these symptoms may not show for months or years. Discussing anything concerning with your doctor as soon as possible can help give you peace of mind and offer the best chance of successful treatment if you receive a CLL diagnosis.

Although CLL has no symptoms in many cases and is often diagnosed during routine blood tests, symptoms may include:

Tiredness
Night sweats
Repeated infections
High temperature
Unexplained weight loss
Swollen, painless lymph nodes under the arms, neck or groin
Enlarged abdomen and feeling full after eating a small amount
Increased bleeding and bruising

Stages of chronic lymphocytic leukaemiaStages of chronic lymphocytic leukaemia

In the UK, CLL is typically staged using the RAI system. This helps doctors understand what your cancer looks like.

The Binet system is also commonly used.

In general, patients with stage III or IV CLL, or those with rapidly growing lymph nodes, will require treatment. Even if your white blood cell count is very elevated, this alone does not mean that you will need to have treatment.

Stage 0

The patient has lymphocytosis with more than 5×10⁹/L , but no other physical signs.

Stage I

The patient has lymphocytosis and enlarged lymph nodes. The patient does not have an enlarged liver or spleen, anaemia or low levels of platelets.

Stage II

The patient has lymphocytosis and an enlarged spleen and/or liver and may or may not have swollen lymph nodes.

Stage III

The patient has lymphocytosis and anaemia. The patient may or may not have swollen lymph nodes and an enlarged liver or spleen.

Stage IV

The patient has lymphocytosis and low levels of platelets. The patient may or may not have swollen lymph nodes, an enlarged liver or spleen, or anaemia.

Treatment for chronic lymphocytic leukaemia

There are many different types of treatment for chronic lymphocytic leukaemia. Your treatment will depend on you and your cancer.

Learn more

Frequently asked questions about chronic lymphocytic leukaemiaFAQs

Is chronic lymphocytic leukaemia hereditary?

CLL is not usually hereditary. However, there are rare cases where CLL can occur in families due to genetic abnormalities. 

What causes chronic lymphocytic leukaemia?

CLL is caused when changes develop in one or more genes (your DNA). The reason for this is not fully known. However, there are some factors which contribute to the risk of CLL developing, including: 

Age – CLL rarely occurs in children
Gender – Men are twice as likely to develop CLL than women
Gene abnormalities and family history – CLL develops when DNA changes promote cell growth and/or stop cells from dying at the right time. In rare cases, CLL can be passed down in families
Exposure to certain chemicals – Radon exposure can increase the risk of CLL.

How common is chronic lymphocytic leukaemia?

CLL accounts for 12.6% of diagnosed blood cancers. 40% of all new CLL cases in the UK are diagnosed in people aged 75 years or over. Over 4,720 people are diagnosed with CLL in the UK every year.

How is chronic lymphocytic leukaemia diagnosed?

There are many different tests that are used to diagnose CLL, alongside a physical examination. This may include blood tests to check your full blood count and determine if leukaemia cells are present.  Some patients may need a lymph node biopsy.  You may need a bone marrow biopsy to check for leukaemia cells within your bone marrow and a CT scan to see which lymph nodes are involved and evaluate the liver and spleen size, although this may not be required at your initial diagnosis.  

What is the difference between chronic lymphocytic leukaemia and chronic myeloid leukaemia (CML)?

CLL and CML are two forms of chronic leukaemia that develop from different types of white blood cells. CLL develops from lymphocytes such as B-cells and T-cells, while CML develops from myeloid cells called granulocytes. 

What can I do to decrease my risk of chronic lymphocytic leukaemia?

There is no known way to prevent CLL. However, there are a number of lifestyle-related factors you can consider to reduce your risk of developing cancer overall, like:

Getting regular exercise – At least 30 minutes of moderate-intensity exercise each day
Eating a healthy, balanced diet – Eat a fibre-rich diet from grain and legume sources, as well as enjoy a variety of fruit (2 serves) and vegetables (5 serves) per day, limit your intake of salt, saturated fats, and avoid all processed meat.

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