What is the outlook for chronic lymphocytic leukemia?


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By
Claire Sissons   
Reviewed
by Christina Chun, MPH
Overview | Survival rates | Life
expectancy | Living with CLL | Takeaway


Survival rates for chronic
lymphocytic leukemia are good compared to many other cancers. Although doctors
cannot often cure the disease, a person can live with this form of leukemia for
many years with treatment.
In this article, we talk about
survival rates for chronic lymphocytic leukemia (CLL) and the factors that can
influence a person’s life expectancy. We also discuss how to achieve a good
quality of life with CLL.
CLL
overview
Leukemia is a type of cancer
that affects the bone marrow and blood. Lymphocytic leukemia begins in the
white blood cells, known as lymphocytes. These cells originate in the bone
marrow.
When a person has lymphocytic
leukemia, white blood cells become leukemia cells, which can spread into the
blood and other parts of the body.
CLL happens when white blood
cells do not fully mature. They cannot fight infection properly, and they build
up in the bone marrow. This means healthy white blood cells do not have as much
room to thrive. Healthy white blood cells are crucial for fighting disease.
CLL does not usually have any
symptoms, and someone may only discover they have it when they have a routine
blood test. If a person does have symptoms, they may include the following:

  • swelling of the lymph nodes in
    the neck, under the arms, or in the groin
  • weight loss without an obvious
    cause
  • extreme tiredness
  • fever or high temperature,
    often due to an infection
There are two forms of CLL.
The cells for each form are slightly different, but doctors can only tell the
cells apart by testing them in a laboratory.
One form of CLL progresses
very slowly, and a person may not need treatment for some time. The second form
progresses more quickly and is considered to be more severe.
Doctors can only very rarely
cure CLL. This means that a person must live with the disease, and is likely to
need ongoing treatment. Often, people do not require treatment for a while.
Older adults are more likely
than others to be affected by CLL, with 70 years being the average age of
diagnosis. Those under the age of 40 years old are very unlikely to experience
this type of cancer.
Survival
rates
Survival rates can give a
person more information about the outlook for their illness and help them to
plan treatment and care. However, survival rates are only ever an estimate.
To find survival rates,
researchers look at information about a group of people with a recent CLL
diagnosis. Five years later, they look at data on the same group of people. The
percentage of people in that group who are still living with the disease 5
years on is the survival rate.
This does not mean that life
expectancy for a person with CLL is 5 years. Researchers typically collect data
for survival rates at 1, 5, or 10 years after diagnosis.
Someone may live significantly
longer than 5 years after a diagnosis of CLL. Researchers base survival rates
on information from people who had a diagnosis of CLL 5 years before. So, if
better treatments have become available in the following 5 years, people who
have had a recent diagnosis may find the survival rates have improved.
In the United States, survival
rates for leukemia have improved significantly over the past 40 years. The
current survival rate for CLL is 83 percent. This means that about 83 out of
every 100 people with CLL will be alive 5 years after diagnosis.
Factors
that influence life expectancy
Doctors talk about stages to
indicate how far cancer has progressed in a person’s body. Because leukemia
affects the blood, doctors cannot stage it in this way.
There are two systems for
staging leukemia: the Rai system and the Binet system. In the U.S., doctors use
the Rai system more commonly.
In the Rai system, a person
will have blood tests to check for cancer cells and to find out how many white
blood cells are in the blood and bone marrow. Alongside a physical exam, this
information can give one of five stages for CLL:

  • Stage 0: Increased number of
    white blood cells.
  • Stage 1: Increased number of
    white blood cells, enlarged lymph nodes.
  • Stage 2: Increased number of
    white blood cells, enlarged spleen, lymph nodes may be enlarged, liver may be
    enlarged.
  • Stage 3: Increased number of
    white blood cells, low number of red blood cells, lymph nodes, liver, or spleen
    may be enlarged.
  • Stage 4: Increased number of
    white blood cells, low number of platelets, number of red blood cells may be
    low, enlarged lymph nodes, liver, or spleen.
A higher stage number means that
CLL is impacting more of the body. A higher stage will often shorten a person’s
life expectancy.
Other factors that can affect
survival rates include:

  • whether CLL has come back or
    improved with treatment
  • how cancer cells have spread
    in the bone marrow
  • if there are changes to a
    person’s DNA and what they are
  • a person’s general health
People often feel better and
live for longer when they receive treatment for CLL. Treatment focuses on
stopping or slowing down the spread of CLL. If the condition is at an early
stage, it may not need treatment.
Treatment options for CLL
include:

  • targeted therapy
  • chemotherapy
  • stem cell transplant
  • drugs to support the immune
    system
After treatment, a person is
likely to have periods of time when they have few or no symptoms of CLL. This
is often known as remission. At the current time, medical professionals do not
know if a person can reduce their risk of CLL coming back.
Living
with CLL
Although there is no cure for
CLL, ongoing treatment can help a person to live with the condition for a long
time. There are several ways that someone who has CLL can support their health
and wellbeing.
Going to all medical
appointments is an essential part of managing any side effects of medication
and treatment. When a doctor sees an individual at regular appointments, they
have the chance to check for signs that CLL may be returning and treat it
quickly.
Staying as healthy as possible
can help with general health and wellbeing. People with CLL may find benefit
from doing gentle exercise and eating a healthful diet.
Many people find living with a
lifelong condition challenging. Getting emotional support and expressing
feelings can help. A listening shoulder may be from friends, family, or
community groups. In the U.S., the American Cancer Society offers information
on local support groups and information services.
Having correct information can
give a person more control and understanding. Finding out as much as possible
about CLL and consulting with a doctor on how to lead a healthy lifestyle can
help with decisions about treatment and care.
Takeaway
Doctors can very rarely cure
CLL. However, survival rates for this cancer are good, particularly with early
diagnosis and treatment. People can live with CLL for many years after
diagnosis, and some can live for years without the need for treatment.
SOURCE:
MEDICAL NEWS TODAY
Kayode Ojo
Kayode Emmanuel Ojo is the Co-Founder and Managing Director at SHEFFA Limited. He is presently studying Computer Science at the National Open University, Victoria Island, Lagos.