Chronic Lymphocytic Leukaemia: What You Need to Know

What happens when your blood doesn’t work quite the way it should—but you feel fine? That’s often how Chronic Lymphocytic Leukaemia (CLL) begins. It's a slow-growing cancer of the blood and bone marrow that many discover during routine check-ups. You might not notice any signs at first, and that can be confusing. But gaining clarity can ease some of the worry. 

This guide is here to help you make sense of CLL in a clear way—so you can move forward with knowledge and confidence.

What is Chronic Lymphocytic Leukaemia?

Chronic Lymphocytic Leukaemia (CLL) is a type of slow-growing blood cancer that begins in the bone marrow and affects white blood cells called lymphocytes. These cells are part of your immune system. In CLL, your body makes too many abnormal lymphocytes that don’t work properly. 

Over time, they can crowd out healthy cells and lead to issues with your immune system and blood production. Many people live with CLL for years, often without symptoms at first. It is typically found during routine blood tests before any health problems are noticed.

Types of Chronic Lymphocytic Leukaemia

There are different forms of CLL, and knowing which type you have can help guide your Chronic Lymphocytic Leukaemia treatment. Most cases involve B lymphocytes, but other less common types exist.

• B-cell CLL: This is the most common type. It affects B lymphocytes, which are responsible for making antibodies. The cancerous B cells multiply slowly and often show up in the blood and bone marrow.
• T-cell prolymphocytic leukaemia (T-PLL): A rare and more aggressive type involving T lymphocytes. Symptoms tend to appear more quickly, and treatment may be more intensive.
• Small lymphocytic lymphoma (SLL): This is essentially the same disease as CLL, but the abnormal cells are mainly in the lymph nodes rather than the blood.
• Prolymphocytic leukaemia (PLL): Can arise from either B or T cells. This type tends to grow faster than typical CLL and may need different management.
• Large granular lymphocytic leukaemia (LGL): A rare type involving T cells or natural killer (NK) cells, often causing autoimmune issues.

Symptoms of Chronic Lymphocytic Leukaemia

Many people discover they have CLL before any symptoms appear. When signs do show up, they tend to develop slowly.

• Fatigue: One of the most common and persistent symptoms, often caused by anaemia or the body working harder to fight infections.
• Swollen lymph nodes: These are usually painless and found in the neck, underarms, or groin. They result from a build-up of abnormal cells.
• Frequent infections: CLL weakens your immune system, making you more prone to bacterial, viral, and fungal infections.
• Night sweats: Profuse sweating while sleeping, even in a cool room, can occur as your body reacts to the disease.
• Unexplained weight loss: Losing weight without trying may be a sign of active disease.
• Fever: Persistent low-grade fevers not linked to infections can happen as part of the body’s inflammatory response.
• Pain or fullness under the ribs: Caused by an enlarged spleen or liver pressing against other organs.

These are the most recognised Chronic Lymphocytic Leukaemia symptoms and can vary in intensity from person to person.

Causes of Chronic Lymphocytic Leukaemia

The exact cause of CLL isn’t known, but researchers have identified several risk factors.

• Genetic mutations: Changes in the DNA of blood-forming cells cause them to grow uncontrollably. Some of these mutations may be inherited.
• Age: CLL occurs most often in older adults, especially those over 60.
• Sex: It is slightly more common in men than in women.
• Family history: Having a close relative with CLL or another blood cancer increases your risk.
• Chemical exposure: Past exposure to certain chemicals, such as herbicides or Agent Orange, may play a role.
• Monoclonal B-cell lymphocytosis (MBL): A non-cancerous condition where you have more B cells than normal. In some people, MBL may develop into CLL over time.

Complications

While many people live well with CLL, some complications can develop, particularly if the disease progresses.

• Frequent infections: The abnormal lymphocytes don’t protect against infections, and your immune system becomes weaker over time.
• Autoimmune issues: In some cases, your body may start attacking its own red blood cells (autoimmune haemolytic anaemia) or platelets (autoimmune thrombocytopenia).
• Richter’s transformation: This is when CLL turns into a more aggressive lymphoma, which requires different treatment.
• Anaemia: The cancer can crowd out red blood cell production, leading to persistent tiredness, pale skin, and shortness of breath.
• Bleeding problems: A reduced number of platelets can lead to easy bruising or bleeding.
• Other cancers: People with CLL may have a slightly higher risk of developing other cancers such as skin, lung, or digestive tract cancers.

Diagnosis

Diagnosing CLL often starts with a routine blood test showing elevated white blood cells. If CLL is suspected, further tests are needed to confirm the diagnosis, check how advanced it is, and plan the best course of action.

Blood Tests

Blood tests are the first step in identifying CLL.

• Full blood count (FBC): Reveals an increased number of white blood cells and may also show low red blood cells or platelets.
• Peripheral blood smear: A sample of your blood is viewed under a microscope to examine the appearance of lymphocytes.
• Flow cytometry: Detects specific markers on lymphocytes to confirm whether they are cancerous.

Other Tests

Other tests give more detail about the disease.

• Bone marrow biopsy: A small sample of bone marrow is taken to check for cancer cells.
• Genetic testing (e.g., FISH test): Identifies mutations or chromosomal changes that may affect your prognosis and response to Chronic Lymphocytic Leukaemia treatment.
• Imaging (CT scans or ultrasounds): Used to check for enlarged lymph nodes, liver, or spleen.

Staging

Staging helps determine how far the cancer has spread.

• Rai system: Used to categorise CLL into low, intermediate, or high risk based on lymphocyte count and organ involvement.
• Binet system: Focuses on the number of affected lymphoid areas and the presence of anaemia or low platelets.

How is Chronic Lymphocytic Leukaemia Treated?

Your Chronic Lymphocytic Leukaemia treatment plan will depend on your overall health, symptoms, and genetic factors. Not everyone needs immediate treatment. In some cases, your doctor may recommend “watchful waiting”, meaning regular monitoring without active therapy until it's necessary.

Targeted Therapy

This modern approach focuses on specific changes in cancer cells.

• BTK inhibitors: Drugs like ibrutinib and acalabrutinib block signals that help CLL cells grow and survive.
• BCL-2 inhibitors: Venetoclax targets a protein that helps leukaemia cells live longer than they should.
• Monoclonal antibodies: These bind to proteins on cancer cells and mark them for destruction by your immune system.

Chemotherapy

Chemotherapy kills fast-growing cells, including cancerous ones.

• Fludarabine and cyclophosphamide: Often used together for effective disease control.
• Bendamustine: A commonly used drug with a good response rate.
• Chlorambucil: Used especially for older patients or those who may not tolerate stronger drugs.

Immunotherapy

This approach uses your body’s immune system to fight cancer.

• Monoclonal antibodies (e.g., rituximab): These help your immune cells attack the cancer.
• CAR T-cell therapy: A newer method under study, where your T-cells are modified to better recognise and attack CLL cells.
• Lenalidomide: A drug that helps improve immune system function and may be used in certain cases.

Alternative Medicine

While alternative medicine cannot replace standard care, some people find it helpful alongside Chronic Lymphocytic Leukaemia medications. It’s always important to speak to your healthcare team before trying any complementary approaches.

Alternative Treatments for Coping with Fatigue

Fatigue is one of the most common issues you might face with CLL.

• Gentle exercise: Activities like walking, yoga, or tai chi can boost your energy over time without overexertion.
• Mind-body techniques: Meditation, breathing exercises, and mindfulness can reduce stress and improve sleep quality.
• Nutritional changes: Eating balanced meals with iron-rich foods, healthy fats, and lean protein can support overall energy levels.
• Acupuncture: Some people report improved fatigue and wellbeing with regular acupuncture sessions.
• Energy conservation: Learning how to pace your activities and prioritise what’s important can help you manage tiredness day-to-day.

Conclusion

Living with Chronic Lymphocytic Leukaemia can feel uncertain, but understanding your condition empowers you to take the next steps with clarity. From recognising symptoms to learning about treatment and supportive care, you're now better prepared to navigate this journey. 

If you are looking for trusted diagnostic services, Metropolis Healthcare offers expert testing, advanced technology, and convenient home sample collection—making it easier to manage your health with confidence and care.

FAQs

Is Chronic Lymphocytic Leukaemia serious?

Yes, Chronic Lymphocytic Leukaemia (CLL) is a serious condition, but it often progresses slowly. Many people live for years with proper monitoring and treatment, and some may never need therapy if the disease remains stable.

Can CLL be cured completely?

There is currently no complete cure for CLL, but many treatments can control it effectively. People often achieve long-term remission, meaning they live without symptoms or progression for years with proper care and monitoring.

Can you live 40 years with CLL?

While uncommon, living several decades with CLL is possible, especially if the disease is slow-growing and managed well. Some people are diagnosed early and live long, full lives with regular monitoring and minimal treatment.

Is CLL genetic?

CLL can run in families, suggesting a genetic link. Having a close relative with CLL or other blood cancers may slightly increase your risk, but most cases occur without a known family history.

Is CLL a tumour?

CLL is not a solid tumour but a type of blood cancer. It involves abnormal white blood cells accumulating in the blood and bone marrow, unlike tumours that form solid masses in organs or tissues.