What are chronic lymphocytic leukemia signs and symptoms?

What are CLL signs and symptoms?

This is a very elusive disease. I mean that the vast majority of patients are not diagnosed because they have symptoms. The most frequent cases
that they are performing tests for other comorbidities like annual regular checkup. And we identify an increased white blood cell count. And then when we characterize the reason for these increases, the clone and leukemic population emerge and we can diagnose that the occurrence of cells. So diseases are usually in a symptomatic disease at the time of the diagnosis. And it's one of the rare blood disorders in which we can get the diagnosis without invasive testing like bone marrow biopsy or aspirate, because the characteristic of delicate cells are so distinctive in the peripheral blood that it takes only blood sampling to identify the presence of CLL then if and when the disease progresses, patient can develop symptoms. The symptoms in the vast majority of cases are related to the occurrence of anemia or thrombocytopenia, but mostly anemia patients can complain about fatigue and they can develop fatigue while they are during daily life activities or specific exercises. But this is not something the patients are complaining about the diagnosis. In general, there are no disease related manifestations. Rarely, the patient reports symptoms that are in general associated with lymphoproliferative disorders like low grade fever, weight loss and drenching night sweats. These are only reported in a minority of patients. It again not to diagnose it, but usually at the time of progression they can be associated with other signs or symptoms of disease progression. And again, at the time of progression, the patient may develop enlarged lymph nodes. Then they can be detectable by physical exam or by imaging tests like abdominal ultrasound. So a lot of times there are there are no signs or symptoms, many, many times CLL is detected. Incidentally, you go to your doctor for your routine labs and all of a sudden you see that some of your white count is a little bit higher than what it used to be and not uncommonly. You go back and they actually been higher and higher and higher for a few years. So in the great majority of times that's how it happens. You're doc- your primary doctor or another doctor is doing labs for something; find out that your counts are a little bit off, send it your hematologist, the blood specialist, to evaluate it. But sometimes the disease can be what brings the doctor, the patient to the doctor. So CLL might have been going on for a little while and then you may have some low count, some anemia. So maybe you're more tired than usual. The disease can be very active and you've been having sweats or losing weight or the lymph nodes are too big and start bothering you, and that brings you to the doctor. So the different ways that the disease will present in the great majority of times, no symptoms whatsoever. It's just really a lab abnormality. And sometimes it will be really the issues that will cause more problems and then bring it to the doctor's attention. When we see patients with CLL, we categorize them whether or not they need treatment. The treatment is based on established criteria by the International Workshop of Chronic Lymphocytic Leukemia or IWCLL. These are established criteria that will indicate when patients require treatment But basically it's a matter of, you know, symptoms or problems that the proliferation, the uncontrolled proliferation of the cells is causing, such as anemia, low platelets, or issues with immune autoimmune thrombocytopenia or anemia or organ getting too enlarged, causing problems. And on a rare occasion, these lymphocytes can actually transform to a more aggressive state, what we call Richter's transformation. And this is more a more type of an aggressive lymphoma at that time with the prognosis is less favorable. They will start getting bruising, weight loss. They can start noticing lumps, they can start having anemia and therefore fatigue, which is very prevalent. They can start having, you know, bleeding issues because the platelets are low and the white count can be very, very high. Even in the over 100,000, it's not uncommon.