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What is chronic lymphocytic leukemia? Discover symptoms and treatment

Actress Susana Vieira, 81 years old, revealed, during an interview with Fantástico on Sunday (19), that she was diagnosed with chronic lymphocytic leukemia . During the conversation, the artist reflected on the challenges people have been facing and revealed that she is in remission.

A chronic lymphocytic leukemia known by its acronym LLC is a type of leukemia — that is, cancer that affects the blood cells in the bone marrow — in which lymphocytes (white blood cells) become cancerous and slowly and progressively replace healthy cells in the lymph nodes, liver and spleen.

According to Abrale (Brazilian Association of Lymphoma and Leukemia), the disease occurs due to a genetic error, in which lymphocytes begin to develop uncontrollably and stop performing their functions. Despite this characteristic, CLL is not an inherited disease It is its causes are still unknown .

The disease is more common in Western countries, mainly North America and Europe, being more common in people over 60 years of age and extremely rare in children. A CLL has no cure .

Possible causes and risk factors

According to Abrale, the exact causes for the development of chronic lymphocytic leukemia are still unknown and few factors have been associated with an increased risk of developing the disease.

However, scientists believe that there may be possible relationships with lifestyle or environmental factors, but there are still no solid scientific conclusions on the subject.

Symptoms of chronic lymphocytic leukemia

According to the MSD Manual, in its initial phases, the chronic lymphocytic leukemia has no symptoms and the disease is detected only due to a high white blood cell count.

As the disease progresses, symptoms such as:

  • Enlarged lymph nodes;
  • Fatigue;
  • Loss of appetite;
  • Weight loss without apparent cause;
  • Enlarged lymph nodes (lumps in the neck, groin and armpit region);
  • Night sweats;
  • Fever unrelated to infection;
  • Shortness of breath during physical exercise;
  • Sensation of abdominal fullness due to enlarged spleen.

How is the diagnosis made?

As there are no initial symptoms, the CLL can be diagnosed by routine blood tests as a blood count . It will be possible to notice changes in blood cell counts, such as an increase in the number of white blood cells. This examination may also be requested by a doctor to investigate the causes of symptoms when they are present.

Detection can also be done through the myelogram , an exam that evaluates the percentage of lymphocytes in the bone marrow, by collecting a small amount of blood in the region. If there is still doubt about the diagnosis, the doctor may request bone marrow biopsy it is a immunohistochemical examination .

There is also the possibility of carrying out specific tests, such as immunophenotyping peripheral blood (karyotype ), essential for the diagnosis of chronic lymphocytic leukemia. In it, it is possible to analyze, together with the myelogram, the cells in a specific way, helping to choose the treatment.

Another possibility is the FISH (fluorescence hybridization in situ), in which a bone marrow or peripheral blood sample is taken (if there are more than 20% of diseased cells in the blood) to detect changes that the karyotype test did not observe.

Finally, you may be asked to node biopsy which detects changes in lymph nodes that may be associated with CLL.

CLL Treatment

Because CLL can progress slowly, in some cases treatment is not necessary until one or more of the following criteria occurs:

  • Emergence of symptoms related to the disease;
  • Anemia (low number of red blood cells) and thrombocytopenia (low number of platelets);
  • Rapidly progressive disease (such as rapid enlargement of lymph nodes, spleen, or liver).

In these cases, treatment may include chemotherapy and immunotherapy , which help to alleviate symptoms and reduce enlargement in lymph nodes and the spleen. However, These treatments do not cure the disease .

In patients with anemia, a blood transfusion may be performed, along with injections of erythropoietin or darbepoetin, medications that stimulate the formation of red blood cells.

Depending on the patient, when the first treatment options do not produce good results, a bone marrow transplant may be indicated to restore the body's ability to produce healthy blood cells.

Source: CNN Brasil

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