• Symptoms of CLL
• CLL diagnosis
• Staging for CLL

Diagnosis: symptoms and tests

What are the symptoms of CLL?

Patients with chronic lymphocytic leukemia (CLL) often learn about their disease after a blood test during a routine checkup or when they have an infection. Sometimes, a person with CLL will find enlarged lymph nodes in the neck, armpit, or groin and go to a healthcare professional. CLL symptoms can include:

• Fatigue
• Weakness
• Fever
• Night sweats
• Shortness of breath during normal activities
• Weight loss
• Swollen lymph nodes or spleen
• Repeated infections

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How is CLL diagnosed?

Common medical tests are used to diagnose illness, determine the stage of CLL, and to monitor treatment progress:

• Physical exam—to check for swollen lymph nodes and other signs of disease
• Blood tests—to assess the number of both healthy cells and CLL cells
• Bone marrow aspiration and biopsy—to show how cells have changed and how many CLL cells there are
• Flow cytometry—to see if the high lymphocyte count is caused by CLL. This test can also show if the CLL is T-cell or B-cell CLL. B-cell CLL is more common (95%)
• Laboratory testing—to see if chromosomes in CLL cells have changed. These changes can give healthcare professionals information that helps them treat individual patients

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Staging for CLL

Healthcare professionals may use Rai staging to indicate the status of the disease and the health of the patient. Once the stage and characteristics of the chronic lymphocytic leukemia (CLL) are determined, the healthcare professional can select the most appropriate treatment.

When staging, healthcare professionals consider:

• The number of CLL cells in the blood and bone marrow
• If the lymph nodes, spleen, or liver are enlarged
• If the patient has a low level of red blood cells (anemia)
• If the patient has a low level of platelets (thrombocytopenia)