symptoms of leukemia | Chronic lymphocytic leukemia

Chronic lymphocytic leukemia

Symptoms
Symptoms of chronic lymphoid leukemia
A disease diagnosed by chance
Given the sometimes very slow evolution of chronic lymphocytic leukemia, patients often have no symptoms, or some unclear symptom. Fatigue, decreased appetite, weight loss or night sweats can be signs of the disease as well. As its evolution is gradual, blood analysis at the onset of the disease can only show a limited increase in white blood cells as well as a slight decrease in red blood cells. In the majority of cases, chronic lymphocytic leukemia is detected by chance, when a simple blood test is taken.

swollen lymph nodes and organs
As the accumulation of lymphocytes becomes more important, the organs in which this phenomenon occurs will increase in size. swollen lymph nodes can be palpated at the neck, armpits or groin. The spleen and liver can also increase in volume and take up more room in the abdomen resulting in a sensation of heaviness or pain in the abdomen.

Evolution in three Stages
In Europe, chronic lymphocytic leukemia is classified in three stages according to the severity of the disease (Binet stages). It is based on the number of ganglion areas for stages A and B. In total, five ganglion areas are distinguished: cervical ganglia, axillary ganglia, inguinal ganglia, liver, spleen. A patient is in stage a when fewer than three ganglion areas are invaded by lymphocytes. In stage B, three or more ganglion areas are reached. In stage C, anemia and/or thrombocytopenia are present.
Treatment is indicated for stages a and B only when the disease evolves or when there are symptoms. On the other hand, stage C always requires treatment.



Chronic lymphocytic leukemia
Diagnosis
1. Diagnosis of chronic lymphoid leukemia
2. Bone marrow and ganglion biopsy: in what cases?
Diagnosis of chronic lymphoid leukemia
Blood sample
The diagnosis of chronic lymphoid leukemia can be posed using a simple blood test. The disease is characterized by an increase in the number of lymphocytes (called lymphocytosis), compared to other types of white blood cells. Their number can climb strongly up to 300,000 per microliter of blood. The increase may also be more limited.

Blood smear
Blood smears are used to determine the shape of the blood cells. This is done by spreading blood on a microscope slide and applying a stain. In the case of chronic lymphocytic leukemia, small and medium-sized lymphocytes are identified. As these are very fragile, they are often destroyed during the making of the smear and only typical residues are still visible. Specialists refer to them as the "Shadows of Gumprecht".

The presence of prolymphocytes, larger lymphocytes in an intermediate stage between immature and mature, is an unfavorable sign. We're talking about prolymphocytic leukemia in this case.

Lymphocyte typing
Lymphocyte typing is indispensable for the diagnosis of chronic lymphoid leukemia. It consists in searching the cell membrane of B lymphocytes of the typical markers of this leukemia. Specific antibodies that bind to these membrane markers are used for this purpose. This process is called immunophenotyping, and can also be done on the bone marrow. This study distinguishes chronic lymphoid leukemia from other forms of leukemia or certain lymphomas.

Cytogenetics
Cytogenetics are used to search the blood for acquired chromosomal anomalies, the origin of chronic lymphoid leukemia. Four anomalies could be identified. They are present in 80% of cases. Some of these anomalies may be accompanied by an adverse prognosis and a poor response to treatment.