How Is CLL Diagnosed?

In the early stages of the disease, there may be no symptoms at all. Many cases of CLL are detected during routine medical examinations of people who show no obvious signs of illness. Usually, the disease is discovered when a routine blood test shows an increase in the white blood cell count. Other patients may be diagnosed after being seen for another condition, such as a chest infection or feeling tired all the time.³ In fact, it is suspected that many cases of CLL remain undetected for many years.

Signs and symptoms

People with CLL find that they^3,8-10:

• Get tired more easily because their blood may be short of red blood cells to carry oxygen
• Get short of breath on exertion—again, a shortage of oxygen to the tissues
• May lose weight-a common symptom of cancer as patients often lose their appetite or don't have the energy to prepare food
• May have frequent infections— because they do not have enough effective white blood cells
• May have enlarged lymph nodes (if these are in the neck, they are often referred to as swollen glands)—cancerous lymphocytes lodge in the lymph nodes and grow there

Other less common symptoms are drenching night sweats, unexplained loss of 10% of body weight, and a fever of more than 100°F (38°C) lasting for more than a week. These are the so-called B-symptoms (which have nothing to do with B cells, a type of white blood cell).^8,10

In the later stages of the disease, the liver and/or spleen may be enlarged.³

Because the bone marrow is not producing enough of the cells called platelets, the blood does not clot properly, so bruises may occur very easily.⁹

All of these signs and symptoms also are caused by other more common and less serious conditions. Therefore, if you think that you are suffering from any of these, see your doctor for a professional diagnosis.

Tests

If your doctor suspects that you may have CLL, you will have a number of tests. These will assist the doctor in deciding whether you have CLL and determining how advanced it is. There are many noncancerous conditions that also produce an increase in the number of lymphocytes in the blood and these have to be ruled out.^8,11

Blood tests
Bone marrow examination
Cell markers
Medical imaging

Staging and prognosis

Based on your symptoms and the results of your tests, your doctor will stage your disease to find out how far it has progressed.³

Most newly diagnosed patients are in an early, symptom-free stage of CLL and have an average life expectancy of around 10 years or more.^9,12 Patients with more advanced disease have a much shorter life expectancy.