Chronic Lymphocytic Leukaemia

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Overview

What is Chronic Lymphocytic Leukaemia (CLL)?

  • CLL is a type of cancer that starts in the white blood cells called lymphocytes.
  • These abnormal lymphocytes build up in the blood, bone marrow, and sometimes in the lymph nodes and spleen.
  • CLL usually progresses slowly over years.

Who is affected?

  • CLL mainly affects adults, especially those over 60 years old.
  • It is more common in men than women.
  • Rare in children.

Causes and Risk Factors

Why does it happen?

  • The exact cause is unknown.
  • CLL starts when a single lymphocyte changes and begins to multiply out of control.

Are certain people more at risk?

  • Risk increases with age.
  • Family history: having a close relative with CLL or another lymphoid cancer raises risk.
  • Exposure to certain chemicals (like herbicides and pesticides, formaldehyde, benzene and other organic solvents) may increase risk.

Symptoms

What are the common signs and symptoms?

  • Many people have no symptoms when first diagnosed.
  • Possible symptoms include:
    • Tiredness and weakness
    • Enlarged lymph nodes (lumps in the neck, armpits, or groin)
    • Frequent infections
    • Fever or night sweats
    • Weight loss without trying
    • Easy bruising or bleeding

Diagnosis

How is it diagnosed?

  • Often found during a routine blood test before symptoms appear.

What tests are commonly done?

  • Blood tests: show high numbers of abnormal lymphocytes.
  • Flow cytometry: helps confirm the diagnosis and the type of leukaemia.
  • Bone marrow biopsy: sometimes needed to check bone marrow involvement.
  • Imaging tests: (e.g., CT scans) may be done if lymph nodes or organs are enlarged.
  • Genetic tests: may be done to help plan treatment.

Treatment Options

What are the treatment choices?

  • Many people with early-stage CLL don’t need immediate treatment (“watch and wait” approach).
  • Treatment is started if there are symptoms or the disease is progressing.

Treatment options include:

  • Targeted therapies: such as ibrutinib, acalabrutinib, zanubrutinib and venetoclax
  • Monoclonal antibodies: rituximab, obinutuzumab
  • Chemotherapy: fludarabine, cyclophosphamide, bendamustine (used less often now)
  • Combination treatments: targeted therapy with monoclonal antibodies
  • Stem cell transplant: rarely, for selected younger patients with aggressive disease

Are there any advanced or investigational therapies?

  • CAR-T cell therapy and new drugs are being studied in clinical trials.

Dietary Advice

What to eat and what to avoid:

  • Eat a balanced diet: plenty of fruits, vegetables, whole grains, and lean proteins.
  • Stay hydrated.

Nutrition tips to support treatment or symptom control:

  • If you have low immunity, avoid raw or undercooked meats, eggs, and seafood.
  • Wash fruits and vegetables well.
  • If losing weight, eat small frequent meals.

Common supplements (if applicable):

  • Only take supplements if recommended by your doctor.
  • Discuss any herbal or over-the-counter products with your healthcare team, as some may interact with medications.

Food safety or drug-food interactions:

  • Grapefruit and its juice may interfere with some CLL medications—ask your doctor if this applies to you.
  • Avoid alcohol if you have low platelets or are on certain treatments.

Living with the Condition

Managing daily activities:

  • Listen to your body and rest as needed.
  • Plan activities when you have the most energy.

Exercise, lifestyle, and emotional well-being:

  • Gentle exercise (walking, stretching) helps maintain strength and mood.
  • Join a support group or talk to a counsellor if feeling anxious or low.

Tips for long-term monitoring and follow-up:

  • Attend all scheduled doctor visits and blood tests.
  • Report new symptoms to your doctor, especially fever or signs of infection.
  • Stay up-to-date with recommended vaccines (discuss with your doctor which are safe).

FAQs

1. Do I need treatment right away?
Not always. Many people are monitored closely (“watch and wait”) until treatment is needed.

2. Will CLL shorten my life?
CLL often progresses slowly, and many people live for many years. New treatments continue to improve outcomes.

3. Can I still work and travel?
Many people with CLL continue normal activities, but you may need to adjust depending on how you feel and your treatment.

4. Should I be worried about infections?
CLL and its treatments can weaken the immune system, so take precautions and contact your doctor if you develop a fever or feel unwell.

5. Can I get vaccinated?
Most inactivated (killed) vaccines are safe. Live vaccines are generally not recommended. Always check with your healthcare team first.

Call to Action

When to contact a doctor:

  • If you have a fever, chills, or signs of infection
  • If you notice unusual bleeding or bruising
  • If you have unexplained weight loss, night sweats, or extreme tiredness
  • Any new or worsening symptoms

Other Information Resources