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CHRONIC LYMPHOCYTIC LEUKEMIA TREATMENT INFORMATION

What is Chronic Lymphocytic Leukemia (CLL)?

Leukemia is a cancer of the white blood cells . It is divided into two general types, Acute and
Chronic. This is based upon their untreated behavior-- with no treatment acute leukemia will kill
within months, while the patient with chronic leukemia may live for many years. Both acute and
chronic leukemias are further subclassified with regard to the particular white cell type they
arose from. Normally, white blood cells act as agents of the body's immune system, recognizing
and destroying foreign invaders such as bacteria, viruses and fungi.

White blood cells are larger than the red blood cells (which carry oxygen) and are easy to see
under the microscope. Too few white blood cells will lead to massive infection, while too few
red blood cells leads to the pallor and fatigue of anemia. Platelets are the third type of blood
element (they are not whole cells) which allow clotting to occur. Too few platelets leads to
bruising and internal bleeding.

Chronic lymphocytic leukemia (CLL) is a cancer of the white blood cells and bone marrow. The
bone marrow is the spongy inner part of bones where blood cells are produced. White blood cells
arise from the marrow and circulate in the blood. Chronic lymphocytic leukemia is characterized
by uncontrolled growth of blood cells.

Many cases of chronic lymphocytic leukemia are detected by routine blood tests in persons with
no symptoms, however, patients may have enlarged lymph nodes, enlarged liver and spleen,
fatigue, bone pain, excessive sweating, loss of appetite, weight loss, flank pain, and generalized
itching. Abnormal bruising, which is a more well known symptom of chronic lymphocytic
leukemia, often does not appear until late in the illness.

Chronic leukemia progresses more slowly than acute leukemia. In leukemia, non-functioning
cells accumulate in the marrow and blood but chronic leukemia enables the body to make greater
numbers of more mature functional cells. The word "lymphocytic" in the term "chronic
lymphocytic leukemia" refers to one of the three types of white blood cells involved in this
disease.

Chronic lymphocytic leukemia (CLL) affects a type of lymphocyte called the B lymphocytes and
causes suppression of the immune system, failure of the bone marrow, and infiltration of
malignant cells into organs. Although chronic lymphocytic leukemia starts in the bone marrow, it
can spread to the blood, lymph nodes, spleen, liver, central nervous system (CNS), and other
organs. It does not usually form a solid mass or tumor.

Chronic leukemia was first recognized in 1845 as a massive accumulation of white blood cells.
There are normally 3,000 to 10,000 white blood cells per milliliter of whole blood, but with
chronic leukemia that number may skyrocket to above 100,000. Ironically, this increased number
of white blood cells will actually lead to more infections, since these abnormal cells are not
effective against fighting germs, and stymie production of normal cells. Thus, chronic leukemia
is also usually accompanied by a decrease in red blood cells and platelets, leading to anemia and
bruising. By contrast, the acute leukemias often have normal or reduced white blood cells.

Besides for acute and chronic, another major division classifying leukemias is between the
lymphoctytic and the myelogenous varieties. The lympho- cytic variety comes from the
lymphocytes, which is a common white blood cell active in identifying and marking germs to be
killed. In adults, about 1/3 of the total white blood cells are lymphocytes. The myelogenous
variety comes from the other white blood cells besides lymphocytes, represents at least 7
different subtypes, and is often just called"non-lymphocytic" leukemia.

The major divisions of acute and chronic, and lymphocytic and myelogenous, are combined in
the following four labels into which leukemias are grouped:

ALL (Acute Lymphocytic Leukemia)


AML (Acute Myelocytic Leukemia)
CLL (Chronic Lymphocytic Leukemia)
CML (Chronic Myelocytic Leukemia)

Like all cancers, leukemia starts from a single abnormal cell, in this case a white blood cell.
Normally, the division of human cells in under very tight control throughout life. The control is
by the genes, which are packets of information within each cell. For any number a reasons, a
cell's genes may be altered and tell the cell to start dividing out of control. For most of the cell
types that form the human body, this will lead to a mass of abnormal cells called a tumor. A
tumor just means a swelling. A tumor which grows only in it's local area, and doesnot spread, is
called "benign" and isn't cancer.

In contrast, a tumor which can spread to any area of the body is called "malignant" and is cancer.
Thus, cancer is proved by it's ability to spread, or "metastasize". Since the blood is unique in
traveling all through the body to nourish it, the same definitions of "spread" cannot be used for
blood cancers (i.e. leukemia) as for "solid tumors" (i.e. lung cancer). The basic way of
distinguishing the many "benign" blood conditions from "malignant" ones is by their behavior.
Generally, benign conditions are not fatal. However, malignant blood diseases will naturally
progress to kill the patient, either quickly (acute leukemia) or slowly (chronic leukemia).

Proper treatment may interfere with this natural progression to death, and possibly even cure the
patient. Since the behavior and effective treatment for acute and chronic leukemias is different,
they are discussed in separate transcripts. Much recent progress have been made in
understanding leukemias, and the relevant points are now summarized in sections.

How Common is Leukemia?


Each year in the United States there are 27,600 new cases of leukemia, with males getting the
disease slightly more often than females. Childhood cases, which are predominantly of the acute
type, are about 7000 cases, so the remaining 20,000 cases occur in adults. The adult cases are
about equally split between the lymphocytic (ALL and CLL) types and the myelogenous types
(AML and CML). For Chronic leukemias, CLL is overall the most common, making up 9,000
cases per year. Men are affected by this type of leukemia twice as often as women, and the
average patient is 65 years old. Ninety percent of CLL patients are over 50 years old.

CLL is not seen in children. On the other hand, CML makes up about 5000 cases per year, is
most common in 30 to 40 year olds, and is occasionally seen in children. Overall, numbers of
leukemia cases have been increasing over the past 3 decades, although survival has been
increasing due to more effective treatments.

What Causes Chronic Leukemia?


As with every cancer, the exact reason why one person gets chronic leukemia and another does
not is unknown . However, several factors have been noted to increase the risk for getting this
disease.

All leukemia comes from blood cells, which normally function to provide the body's cells with
oxygen (red blood cells), protect them from invading germs (white blood cells), and promote
blood clotting after an injury (platelets). This system usually functions beautifully, and it's proper
workings are crucial to human life. These blood cells division is normally under tight control,
and when a cell starts dividing out of control, it becomes "cancerous."

Cancer starts in just one cell! Chronic leukemias are cancers of blood cells, and are one of two
basic types. Firstly, "Chronic Lymphocytic Leukemia" (CLL) which starts in a popular type of
white blood cell ("lymphocyte"), and the second is ÒChronic Non-Lymphocytic LeukemiaÓ
(CNLL) which includes cancers arising from every other type of blood cell besides the
lymphocyte. "Chronic Myelocytic Leukemia" (CML) is the most common type in this second
category.

It is critical to get prompt diagnosis and proper treatment for chronic leukemia; this can literally
make the difference between life and death. Understanding your options will give you the peace-
of-mind of knowing you have done everything possible to ensure a successful outcome for
yourself or a loved one.

Our material explains, in plain English, the definition, types, risk factors, frequency, symptoms,
evaluations, historical and latest effective treatments for chronic leukemia. We describe
chemotherapy, radiation, new immune therapies and bone marrow transplantation, along with
their side-effects and results. While we don't promise a cure, tell you everything you must know
to help you make the right choices today for dealing with a chronic leukemia problem.

You won't find this combination of information anywhere else. It is easily accessible right here.
We invite you to read our review on Chronic Lymphocytic Leukemia so that you will be armed
with comprehensive, trustworthy information that may help you or someone you care about who
has been diagnosed with Chronic Lymphocytic Leukemia.