Chronic lymphocytic leukemia (CLL) is a type of cancer in your blood. It’s the most common form of leukemia in adults. Currently, healthcare providers don’t have treatments to cure chronic lymphocytic leukemia. But they do have treatments to put the condition into remission, meaning you don’t have CLL symptoms or signs of it.
Chronic lymphocytic leukemia (CLL) is a type of blood cancer. It’s the most common form of leukemia in adults. It happens when healthy white blood cells (lymphocytes) in your bone marrow mutate, or change, into cancerous cells that multiply and crowd out healthy blood cells and platelets.
CLL typically affects people aged 65 and older, but it can affect people starting at age 30. You can have chronic lymphocytic leukemia without having symptoms. Most people learn they have CLL after having blood tests as part of routine physical examinations.
Currently, healthcare providers don’t have routine treatments to cure chronic lymphocytic leukemia. During the past 10 years, providers have developed treatments that put CLL into remission. (Remission means you don’t have symptoms and signs of CLL.) These treatments are helping people with CLL live longer.
Nearly all people with CLL have B-cell chronic lymphocytic leukemia. There’s a related condition that affects T-cells called T-cell prolymphocytic leukemia (PLL). People with T-cell PLL develop symptoms more quickly than people who have B-cell CLL.
Chronic lymphocytic leukemia is one of the most common types of leukemia in adults. It affects about 5 in 100,000 people in the U.S. The American Cancer Society estimates about 18,700 people will be diagnosed with CLL in 2023. By comparison, more than 238,000 people will be diagnosed with lung cancer in 2023 (one of the most common cancers overall).
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You can have chronic lymphocytic leukemia without symptoms. It may take months to years before you notice CLL symptoms. Common symptoms include:
Chronic lymphocytic leukemia happens when certain chromosomes and genes mutate or change during your lifetime. Medical researchers don’t know what triggers those changes, but they’ve identified some risk factors, including:
Chronic lymphocytic leukemia affects your red blood cells, white blood cells and platelets. Red blood cells carry oxygen throughout your body. White blood cells protect you from infection. Platelets help your blood to clot. Without healthy blood cells and platelets, you may develop the following complications:
Your healthcare provider will ask about your symptoms. They’ll do a physical examination, and may order the following tests:
Healthcare providers use cancer staging systems to develop treatment plans and prognoses (expected outcome). Providers stage CLL with two similar staging systems. The Rai staging system categorizes CLL by the likelihood the condition will get worse and require treatment. The Binet system stages CLL by how much the condition has spread throughout your body.
The Rai staging system categories are:
The Binet staging system uses information about your blood cell and platelet count and the number of areas in your body with swollen lymph nodes. Binet staging system categories are:
Some people with cancer feel intimidated or unnerved by systems that seem to reduce their condition to a formula of numbers and letters. Your providers understand why you may feel this way. If you’re confused or concerned by what you’re hearing, ask your provider to explain how the cancer staging system works in your situation.
Treatment varies based on your symptoms and test results. For example, if you have early-stage CLL, your healthcare provider may opt for watchful waiting (active surveillance).
In watchful waiting, providers hold off on treatment while carefully monitoring your overall health, symptoms and test results.
Providers also consider genetic test results. For example, certain genetic changes mean your condition is likely to get worse sooner rather than later or typical CLL treatments won’t be as effective.
Common CLL treatments include targeted therapy and chemotherapy. Providers may use radiation therapy to ease CLL symptoms. Each treatment type may cause different side effects. Your provider will outline specific treatment benefits, side effects and potential long-term complications.
This treatment works by targeting or focusing on cancer cells. In chronic lymphocytic leukemia, treatments keep cancerous white blood cells from growing. Some targeted treatments destroy the cells without hurting healthy cells or platelets. Specific treatments or medication may include:
Your healthcare provider may use chemotherapy as an initial treatment for chronic lymphocytic leukemia. Common chemotherapy drugs for CLL include:
This treatment works by restoring or strengthening your immune system so it can do more to kill cancerous cells or slow down cancerous cell growth.
Providers may use the immunotherapy drug lenalidomide (Revlimid®) to treat chronic lymphocytic leukemia that hasn’t responded to chemotherapy, CLL that’s come back (recurrent CLL) or CLL that’s getting worse.
Medical researchers are evaluating chimeric antigen receptor (CAR-T) therapy for people with CLL that hasn’t responded to standard treatment.
There’s no known way to prevent CLL.
Chronic lymphocytic leukemia (CLL) typically develops very slowly. You can live for a long time with CLL before you notice symptoms. When you do, healthcare providers have very effective treatments that put CLL into remission. Remission from CLL typically lasts for several years before the condition comes back. Even then, your provider may recommend different treatments that put CLL back into remission. CLL never goes away, but people can still live a long and full life with the disease.
The National Cancer Institute estimates 87.9% of people with CLL are alive five years after diagnosis. When you think about survival rates, it’s important to remember survival rates are estimates based on the experiences of large groups of people with CLL. Many things may affect CLL survival rates, from your overall health and the condition stage at diagnosis, to how your condition responds to treatment. If you have questions, ask your provider what you can expect in your situation.
The term “end-stage” means treatment no longer works to slow or stop CLL. In that case, you may develop life-threatening infections or uncontrollable bleeding that healthcare providers aren’t able to cure.
That depends on your situation. You can have CLL without having any symptoms. If you have symptoms, there are treatments to reduce them and manage your condition, but it never goes away.
Here are some suggestions for living with CLL:
You may want to ask:
A note from Cleveland Clinic
Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in adults. You can have chronic lymphocytic leukemia for years without having any symptoms. If you have CLL, you may not need treatment right away. Healthcare providers can’t cure it, but they can provide treatments to eliminate CLL symptoms and signs of disease, putting the disease into remission. Some people with CLL live for many years. Living with a chronic illness like CLL isn’t always easy. You may go through several cycles of remission and recurrence. With each cycle, you may worry about what’s next. Your providers understand what it’s like to live with a chronic illness. They’ll be glad to answer any questions and help you as much as they can.
Last reviewed by a Cleveland Clinic medical professional on 01/31/2023.
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