A CLL diagnosis comes with new challenges, from understanding signs and symptoms and what the different stages mean.
Signs and Symptoms
Most people with chronic lymphocytic leukemia (CLL) do not have symptoms when they receive their diagnosis. Typically, the first sign of the disease occurs when a blood test ordered for an unrelated health condition or a routine checkup reveals a high number of white blood cells called lymphocytes. As the disease progresses, symptoms may include:
Determining a Diagnosis
The doctor will start by taking a complete medical history and doing a physical exam to look for possible signs of leukemia. These tests are also available to diagnose and classify leukemia.
Doctors use a staging system to describe a patient’s cancer — there are two systems for CLL.
The Rai system, which classifies cancer according to risk, is used most often in the United States.
The Binet staging system is more common in Europe.
In addition to staging, doctors will use other factors to determine the prognosis. Favorable factors include a low proportion of CLL cells with ZAP-70 or CD38, deletion of part of chromosome 13, IGHV mutational status and a non-diffuse pattern of bone marrow involvement. Factors linked to a shorter survival time include advanced age, deletions of parts of chromosomes 17 or 11, TP53 mutations or a high proportion of cells with ZAP-70 or CD38, and a diffuse pattern of bone marrow involvement.