2 OverviewChronic lymphocytic leukemia (CLL) is cancer of the blood and bone marrow.The term "chronic" comes from that it progresses more slowly than other types of leukemia. The term "lymphocytic" comes from the cells affected by the disease
3 Overview 15,000 ppl each year in the United States It is the most common type of leukemia in adults.Most of those who get it are older than 55.Average age is 72More common in men In some people can remain slow-growing for years and never need treatment.
4 How it developsLymphocytes evolve from immature cells called hematopoietic stem cells.Healthy lymphocytes evolve through their life cycle eventually die.In CLL, changes in the diseased cells prevent them from maturing properly.They have a longer life span.Over time, accumulate in the bone marrow and in the tissues of the lymphatic systemInterfering with other immune system functions.
5 SymptomsMany people with chronic lymphocytic leukemia have no symptoms. Those who do develop signs and symptoms may experience:Enlarged, but painless, lymph nodesFatigueFeverNigh sweats t Weight loss Frequent infection Pain in the upper left portion of the abdomen, which may be caused by an enlarge spleen n
6 Risk FactorsInherited or genetics, traits and exposure to cancer-causing agents in the environment.Relatives such as a parent, child, or sibling, with CLLMost cases its associated with specific gene mutation
7 Diagnosis Many types of tests are performed Tests can reveal abnormatlities in cellsAmount of blood cellsChanges in bone marrowOther factors in deciding the course of treatmentCommon Tests Used:Cytogenetic studies, Immunohisto-chemistry studies,Flow cytometry, and Molecular genetic studies
8 Diagnosis cont. In the Blood Blood Test Complete Blood Count Low numbers of RBCPlatelet levels lowNormal WBC levels diminished
9 Diagnosis cont.Bone Marrow Aspirates & BiopsiesPhysical ExaminationBone Marrow biopsies- remove small peice of bone and marrow for examinationAspirate- Withdraw Small sample of liquid bone marrowDoctor will check:Lymph NodesSpleenLiverFirst sign can be enlarged spleen or liver
10 ClassificationClassify or stage each patients CLL according to how far the disease has progressedRai SystemStage 0Stage IStage IIStage IIIStage IV
11 Treatment No treatment yet that is considered a cure They are designed to slow progression of diseaseCLL develops very slowly
12 Treatment Cont. Radiation Therapy Used in rare cases Uses high-energy raysDestroys cancer cellsControls enlarged lymph nodes or spleen
13 Treatment Cont. Stem Cell Transplant For some patients Obtain stem cells by filtering from blood streamThen treated with high- dose of chemo.Doctors then transplant harvest stem cells
14 Treatment Cont.On going Care: People with CLL are likely to see their physician often to monitor the disease and to determine if it is progressing. These check-ups may include a physical exam, blood tests, bone marrow aspirates, biopsies, and radiographic studies.
15 Prognosis Out come depends on a few things Change in DNA? Lymphocytes spread throughout bone marrow?The Stage of CLLTreatment helping or not?General Health
16 Prognosis: What are the Survival Rates? 5 year Survival rateTreatment and responses to treatment vary greatlyThe five-year relative CLL survival rates by race and sex were:~ 74.3% for Caucasian men ~ 77.1% for Caucasian women ~53.8% for African American men~ 62.2 %for African American women.