Key Points about Chronic Lymphocytic Leukemia (CLL)

  • Chronic lymphocytic leukemia most often occurs in older adults.
  • Doctors use imaging tests, biopsy, blood tests, spinal taps and physical exams to diagnose CLL.
  • Treatment for CLL may include chemotherapy, targeted therapy and/or stem cell transplant.


Chronic lymphocytic leukemia – or CLL – is a type of cancer that affects the blood and bone marrow. Bone marrow is the spongy tissue located inside the bones. CLL progresses more slowly than acute lymphocytic leukemia and affects a group of white blood cells called lymphocytes.

Chronic lymphocytic leukemia causes

CLL is caused when bone marrow cells develop a mutation (change) in their DNA.

Chronic lymphocytic leukemia risk factors

The following factors may increase your risk for developing CLL:

  • Being Caucasian
  • Being exposed to certain harmful chemicals, such as herbicides, insecticides and Agent Orange (used during the Vietnam War)
  • Being older
  • Having a family history of blood and bone marrow cancers
  • Having monoclonal B-cell lymphocytosis (MBL)

Chronic lymphocytic leukemia symptoms

Signs and symptoms of CLL can include:

  • Fatigue
  • Fever
  • Frequent infections
  • Night sweats
  • Pain in the upper left area of the abdomen (caused by a swollen spleen)
  • Swollen, painless lymph nodes
  • Unintentional weight loss

Chronic lymphocytic leukemia diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

  • Physical exam – your doctor will perform a complete physical exam, including asking questions about your health history, symptoms and related risk factors. 
  • Blood tests – your doctor will send a sample of your blood to the laboratory for close analysis. The lab can determine if the blood has unusual levels of lymphocytes, which can indicate CLL.
  • Bone marrow biopsy – in this test, your doctor removes a biopsy (small tissue sample) from the bone marrow. This sample is sent to the laboratory, where a specialist closely checks the biopsy for cancerous cells. 
  • Computerized tomography (CT) scan – this type of imaging test provides a 3D image of the inside of the body that your doctor can use to determine the size and location of the suspected cancer. Your doctor can also use the CT scan to help determine if cancer has spread beyond the initial site.

Chronic lymphocytic leukemia treatment

Depending on your personal health history, the extent of the CLL and other factors, your oncologist may recommend one or more of the following treatment options:

  • Watchful waiting – if you are not experiencing any symptoms related to CLL and it does not seem to be progressing quickly, you may not need to undergo treatment right away. In this case, you will continue to see your doctor for regular check-ups and testing to monitor the condition.
  • Bone marrow transplant – also known as a stem cell transplant, this treatment involves infusing your diseased bone marrow with healthy bone marrow. Doing so can help your body fight the cancer.
  • Chemotherapy – during this treatment, medication is used to destroy cancerous cells. Chemotherapy can be taken via an oral (by mouth) pill or intravenously (through a vein).
  • Stem cell transplant – this treatment involves infusing healthy stem cells into your blood to help your body destroy cancerous cells and resume healthy white blood cell production.
  • Targeted therapy – in this treatment, specialized medications kill cancerous blood cells. Targeted therapy may help preserve more surrounding healthy tissue than other treatment options.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.

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