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Chronic Lymphocytic Leukemia
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Blood Heart Circulation

Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is a slow-progressing cancer of the white blood cells that often affects adults during or after middle age.

What is Leukemia?

Leukemia is a term for cancers of the blood cells that start in blood-forming tissues such as the bone marrow. The bone marrow produces cells that develop into white blood cells (which fight infection), red blood cells (which deliver oxygen), and platelets (which help form clots). In leukemia, the bone marrow produces large numbers of abnormal cells—most often white blood cells—that crowd out healthy cells.

Understanding Chronic Lymphocytic Leukemia (CLL)

Chronic lymphocytic leukemia (CLL) is a type of chronic leukemia, meaning it usually worsens slowly. In CLL, the bone marrow makes abnormal lymphocytes. These abnormal cells can crowd out healthy cells, leading to infection, anemia, and easy bleeding, and may spread to other parts of the body. It is one of the most common types of leukemia in adults and is rare in children.

Causes and Risk Factors

CLL is caused by changes in the genetic material (DNA) in bone marrow cells. While the exact cause of these changes is unknown, risk factors include:

  • Age: Risk increases with age; most people diagnosed are over 50.
  • Family history: A history of CLL or other blood and bone marrow diseases.
  • Racial/ethnic group: More common in whites than in other groups.
  • Chemical exposure: Exposure to certain chemicals, such as Agent Orange.

Symptoms

CLL often causes no symptoms initially. Later symptoms may include:

  • Swollen lymph nodes (painless lumps in the neck, underarm, stomach, or groin)
  • Weakness or fatigue
  • Pain or fullness below the ribs
  • Fever and infection
  • Easy bruising or bleeding
  • Petechiae (tiny red dots under the skin caused by bleeding)
  • Unexplained weight loss
  • Drenching night sweats

Diagnosis

Healthcare providers use several tools to diagnose CLL:

  • Physical exam and medical history
  • Blood tests, including a complete blood count (CBC) with differential and blood chemistry tests (e.g., BMP, CMP, kidney/liver function tests).
  • Flow cytometry to identify leukemia cells.
  • Genetic tests to look for gene and chromosome changes.

Additional imaging or bone marrow tests may be used to determine if the cancer has spread.

Treatment and Management

Treatment goals are to slow cancer growth and achieve remission. Options include:

  • Watchful waiting: Regular monitoring without immediate treatment.
  • Targeted therapy: Drugs that attack specific cancer cells.
  • Chemotherapy
  • Radiation therapy
  • Immunotherapy
  • Chemotherapy with bone marrow or stem cell transplant

Frequently Asked Questions

When active treatment for CLL is needed, options often include targeted therapies, such as Bruton's tyrosine kinase (BTK) inhibitors or BCL-2 inhibitors, which specifically target cancer cells. Chemotherapy, immunotherapy (using monoclonal antibodies), or a combination of these may also be used. In rare cases, a stem cell transplant might be considered for younger patients with high-risk disease.
People with CLL have a weakened immune system, making them more susceptible to infections. Key precautions include practicing good hand hygiene, avoiding close contact with sick individuals, staying up-to-date on recommended vaccinations (like flu and pneumonia shots, but avoiding live vaccines), and promptly reporting any signs of infection (fever, chills, unusual pain) to their healthcare team. Prophylactic antibiotics or antiviral medications may also be prescribed in some cases.
"Watch and wait" is a common initial approach for many CLL patients, especially those with no symptoms or mild symptoms. It means that instead of starting immediate treatment, your doctor will regularly monitor your blood counts, symptoms, and overall health. Treatment is typically initiated only when the disease progresses, causes significant symptoms, or affects organ function, as early treatment doesn't always improve overall survival for asymptomatic patients.
CLL is frequently discovered incidentally during routine blood tests, such as a complete blood count (CBC), performed for other reasons. These tests may reveal an abnormally high number of lymphocytes (a type of white blood cell). If an elevated lymphocyte count is found, further specialized blood tests, like flow cytometry, are then used to confirm the diagnosis of CLL.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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