Journal of Leukemia
Open Access

A Brief Note on Chronic Lymphocytic Leukemia

Stefano Carugo^{* *}Correspondence: Stefano Carugo, Department of Clinical Sciences and Oncology, University of Milan, Milano MI, Italy, Email:

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Description

CLL (Chronic Lymphocytic Leukaemia) is a blood and bone marrow malignancy that affects the spongy tissue inside bones where blood cells are generated. The word "chronic" originates from the fact that chronic lymphocytic leukaemia usually advances more slowly than other types of leukaemia. In chronic lymphocytic leukaemia, the term "lymphocytic" refers to the cells that are impacted by the disease, which are a type of white blood cell called lymphocytes that assist your body fight infection.

Symptoms of chronic lymphocytic leukaemia

The majority of people with chronic lymphocytic leukaemia are above the age of 50 years. Treatments are available to help control the condition. At first, many persons with chronic lymphocytic leukaemia have no symptoms. As the cancer grows, signs and symptoms may appear. They could include the following:

• Enlarged, but painless, lymph nodes

• Fatigue

• Fever

• Pain in the upper left abdomen, which could be the result of an enlarged spleen

• Night sweats

• Weight loss

• Infections on a regular basis

Causes of chronic lymphocytic leukaemia

Individuals are not sure what causes the chronic lymphocytic leukaemia process. What's known is that something happens to cause changes in the DNA of blood-producing cells, causing mutations. The instructions that inform a cell what to do are encoded in its DNA. The changes in the blood cells to produce useless lymphocytes those are abnormal. These abnormal lymphocytes not only are useless, but they also live and reproduce when healthy lymphocytes would expire. The aberrant cells build up in the blood and in specific organs, causing problems. They may move healthy cells out of the bone marrow, interfere with the production of blood cells. Few of are struggling to understand how chronic lymphocytic leukaemia develops [1].

Risk factors

• Age is one factor that may raise your risk of chronic lymphocytic leukaemia. The majority of people who get this condition are above the age of 60 years.

• White people are more likely than those of other races to acquire chronic lymphocytic leukaemia.

• Cancers of the blood and bone marrow in the family: A family history of CLL or other blood and bone marrow malignancies may raise your risk.

• Chemical exposure is a concern: Certain herbicides and insecticides have been associated to an increased risk of chronic lymphocytic leukaemia, including Agent Orange.

• A condition characterized by an excess of lymphocytes: MBL (Monoclonal B-cell Lymphocytosis) is a condition in which the quantity of one kind of lymphocyte (B cells) in the blood increases. MBL sometimes can develop to chronic lymphocytic leukaemia in a minority of patients. People seem to be at a higher risk of developing cancer when they have MBL plus a family history of chronic lymphocytic leukaemia [2].

Complications

Complications of chronic lymphocytic leukaemia include: Frequent infections, if some individual have chronic lymphocytic leukaemia, they may have infections on a regular basis, which can be dangerous [3]. Infections can occur when they blood requires additional germ-fighting antibodies (immunoglobulins). Regular immunoglobulin infusions are sometimes recommended by the doctor.

• A change to a more aggressive cancer kind. A tiny percentage of persons with chronic lymphocytic leukaemia develop diffuse large B-cell lymphoma, a more severe form of cancer. Doctors sometimes refer to this as Richter's syndrome.

• An increased chance of developing additional malignancies: People with chronic lymphocytic leukaemia are more likely to develop other cancers, such as skin cancer, lung cancer, and digestive system cancer.

• Issues with the immune system: A small percentage of persons with chronic lymphocytic leukaemia may have an immune system issue that causes the immune system's disease-fighting cells to mistakenly target red blood cells (autoimmune hemolytic anaemia) or platelets (autoimmune thrombocytopenia).

Diagnosis

Blood tests aimed to count the number of cells in a blood sample are one of the tests and procedures used to diagnose chronic lymphocytic leukaemia. The quantity of lymphocytes in a blood sample can be determined using a complete blood count. B cells, a type of lymphocyte, in huge numbers may indicate chronic lymphocytic leukaemia [4]. Determine that these lymphocytes are present, flow cytometry, also known as immune phenotyping, is a test that determines whether an increase in lymphocytes is produced by chronic lymphocytic leukaemia, another blood disorder, or depending on body's response to another process, such as infection. If chronic lymphocytic leukaemia is present, flow cytometry can also be used to look for features in the leukaemia cells that can help predict how aggressive they are. Examine for genetic alterations in lymphocytes. Fluorescence in Situ Hybridization (FISH) is a procedure that examines for abnormalities in the chromosomes of malignant cells [5].

Other examinations tests and treatment such as: Biopsy and aspiration of the bone marrow, Computerized Tomography (CT) and Positron Emission Tomography (PET) are two types of diagnostic techniques.

Staging: The facts about cancer to establish the stage of the chronic lymphocytic leukaemia once a diagnosis has been confirmed. The stage indicates how aggressive the patient's cancer is and how soon it is anticipated to worsen. Letters or numbers can also be used to specify the stages of chronic lymphocytic leukaemia. In general, the earliest stages of disease need not require immediate treatment. People with advanced cancer must consider starting treatment right away [6].

Conclusion

Chronic lymphocytic leukaemia needs treatment. Chemotherapy is a drug that kills cells that proliferate quickly, such as cancer cells. Chemotherapy can be given intravenously or in tablet form. Depending on the situation, a single chemotherapy treatment or a mixture of the two of medications may be used. With a specific purpose in mind, drug therapy is used. Specific abnormalities detected in cancer cells are targeted by targeted pharmaceutical treatments. By blocking these abnormalities, targeted drug therapies can kill cancer cells. Immunotherapy is a type of cancer treatment that depends on immune system to fight the disease. The body's disease-fighting immune system may fail to fight cancer because cancer cells develop proteins that help them hide from immune system cells. Immunotherapy works by altering the immune system's natural process.

References

1. Hallek M. Chronic lymphocytic leukemia: 2020 update on diagnosis, risk stratification and treatment. Am J Hematol. 2019;94(11):1266-1287.

   [CrossRef], [PubMed], [Google Scholar]

2. Grywalska E, Zaborek M, Łyczba J, Hrynkiewicz R, Bębnowska D, Becht R, et al. Chronic lymphocytic leukemia-induced humoral immunosuppression: A systematic review. Cells. 2020;9(11):2398.

   [CrossRef], [PubMed], [Google Scholar]

3. Angelillo P, Capasso A, Ghia P, Scarfò L. Monoclonal B-cell lymphocytosis: Does the elderly patient need a specialistic approach? Eur J Intern Med. 2018;58:2-6.

   [CrossRef], [PubMed], [Google Scholar]

4. Choi SM, O'Malley DP. Diagnostically relevant updates to the 2017 WHO classification of lymphoid neoplasms. Ann Diagn Pathol 2018;37:67-74.

   [CrossRef], [PubMed], [Google Scholar]

5. Gribben John G. Stem cell transplantation in chronic lymphocytic leukemia. Biol Blood Marrow Transplant. 2009;15(1):53-58.

   [CrossRef], [PubMed], [Google Scholar]

6. Rai KR, Peterson BL, Appelbaum FR, Kolitz J, Elias L, Shepherd L, et al. Fludarabine compared with chlorambucil as primary therapy for chronic lymphocytic leukemia. N Engl J Med. 2000;343(24):1750-1757.

   [CrossRef], [PubMed], [Google Scholar]