Chronic lymphocytic leukemia (CLL) is the most common form of blood cancer in adults. Chronic lymphocytic leukemia has a variable course. CLL can be mild for years and may not require treatment, or be aggressive and, despite refractory treatment, lead to death. What are the causes and symptoms of chronic lymphocytic leukemia? What is its treatment?
Chronic lymphocytic leukemia (CLL)(akalymphocyticorCLL- chronic lymphocytic leukemia ) is a cancer of the blood that belongs to the group of chronic lymphocytic leukemias.
Its essence is the uncontrolled multiplication and accumulation of cancerous lymphocytes (white blood cells) in the blood and bone marrow, and with time also in the lymph nodes, spleen and liver.
As the disease progresses, they "displace" he althy blood cells and expand further.
90 percent cases of leukemia originating in B cells, cases of T and NK cells (Natural Killers) are rare.
Chronic lymphocytic leukemia (CLL) is one of the most commonly diagnosed blood cancers in Poland.
Chronic lymphocytic leukemia is the most commonly diagnosed type of leukemia in adults, accounting for 25-30% of the population. all leukemias .
It is diagnosed mainly in the elderly - as much as 70 percent. CLL patients are people over 65 years of age.
Currently, the disease affects 17 thousand. people, however, experts emphasize that the group of patients will grow every year.
It is important that 7 percent patients struggle with an aggressive form of chronic lymphocytic leukemia. This form of leukemia is resistant to treatment and, despite the therapy, develops as if it had not been treated, in such a situation the survival of patients is 3-4 years.
Causes of Chronic Lymphocytic Leukemia
Scientists speculate that genetic predisposition may be an etiological factor, as there have been cases of familial occurrence of this disease.
The causes of chronic lymphocytic leukemia are unknown.
At its base, as is the case with many cancers, they liegenetic mutations detected in over 80 percent. patients with chronic lymphocytic leukemia.
Chronic Lymphocytic Leukemia - Symptoms
The course of chronic lymphocytic leukemia is varied and often asymptomatic.
About 30 percent patients at the time of diagnosis do not have any symptoms of the disease. In the remaining patients, the symptoms may be different and non-specific, depending on the stage of the disease.
U approx. 30 percent patients, the disease does not show any symptoms.
The most common symptom of chronic lymphocytic leukemia is painless enlargement of the peripheral lymph nodes (lymphadenopathy) and fatigue. Other symptoms, such as:
- weight loss greater than 10% within 6 months
- elevated body temperature for more than 2 weeks
- night sweats
occurs in approx. 10 percent sick.
In other patients, the main symptom of the disease may be complications related to CLL, such as decreased red blood cells and platelets, decreased immunity and increased susceptibility to infections.
30% of leukemia patients do not have symptoms at diagnosis [REPORT]
Source: Youtube.com
Chronic lymphocytic leukemia - diagnosis
Blood tests are the basis of diagnostics. The final diagnosis is made when blood lymphocytosis, i.e. an increase in the number of lymphocytes in the blood that cannot be explained by other diseases, persists for more than three months.
In Poland, there is limited access to specialists and cytogenetic tests, which are necessary for the proper selection of an effective therapy.
The percentage of patients undergoing this study does not exceed 20%.
Importantly, there is also a shortage of hematologists in Poland.
Currently on 100,000 people there are 1.3 thous. hematologists, which is one of the worst indicators in all of Europe. The result is long queues and extended waiting times for medical consultations.
Chronic Lymphocytic Leukemia - Treatment
Pharmacotherapy plays a major role in the treatment of chronic lymphocytic leukemia.
Currently, the standard of care in most cases is chemotherapy combined with immunotherapy.
CLL remains an incurable disease, except in a few cases where bone marrow transplantation from a family or unrelated donor, the so-called allogeneic transplant (alloSCT).
This procedure is only performed on young people ( <65 roku życia) i wiąże się z dużym ryzykiem powikłań i dużą śmiertelnością.
So far, the goal of treatment was to eliminate general symptoms,counteracting cytopenias and controlling the number of leukocytes.
Currently, in connection with the introduction of new methods of treatment, the goal is - especially in younger people - to achieve complete remission, and even to eradicate residual disease, which contributes to the prolongation of disease-free and overall survival of patients
Currently, the greatest therapeutic challenge is the treatment of patients with aggressive CLL.
- Standard medications that are available today do not work for aggressive forms of chronic lymphocytic leukemia. Patients, provided that they are young and have no other comorbidities, can only be treated with bone marrow transplantation. On the other hand, the elderly cannot undergo these procedures due to their toxicity, and therefore they require different treatment. Targeted drugs are needed that inhibit individual enzymes essential for the development of leukemia, says Prof. Newseria Biznes agency. Wiesław Jędrzejczak, national consultant in the field of hematology.
More than 3 years ago, medicine was powerless and had no offer for patients with an aggressive form of chronic lymphocytic leukemia, innovative therapies registered four years ago - small molecule targeted drugs and monoclonal antibodies - turned out to be breakthroughs in the treatment of this group of patients.
- Progress in the field of blood cancer treatment concerns mainly the introduction of more and more new targeted drugs. They come from two technological groups. On the one hand, these are monoclonal antibodies, and on the other hand, small-molecule, synthetic drugs, which are specific inhibitors of genes that are responsible for the neoplastic behavior of cells - explains Prof. Newseria Biznes agency. Wiesław Jędrzejczak.
As the authors of the White Book indicate, Poland is currently the only country in Central and Eastern Europe that does not offer any effective therapy to patients with an aggressive form of CLL. - These sick people have "lights out". They do not have access to modern therapies because they are not reimbursed in Poland. Not only do the patient and his whole family suffer mentally, but they do not yet have treatment options that are available in the Czech Republic and Hungary, for example. This is a very dramatic situation and we will fight to ensure that patients receive the right treatment - says the Newseria agency Jacek Gugulski, president of the PBSz Association, the Council of Patients with Blood Cancer.
There is a chance for patients with chronic lymphocytic leukemia
Source: biznes.newseria.pl
Chronic lymphocytic leukemia - prognosis
Chronic lymphocytic leukemia in 1/3 of cases is mild, over timeexperiences reaching even 10-20 years.
In other cases, the disease may be aggressive from the beginning and lead to death within a few years or after a period of mild course, result in severe complications and death.
Source: "Report" White Book - Chronic Lymphocytic Leukemia ", March 2022.