B-cell chronic lymphocytic leukemia

B-cell chronic lymphocytic leukemia (B-CLL) is a type of cancer that originates in the B lymphocytes of the immune system. It is characterized by the accumulation of abnormal, mature B cells in the bone marrow, bloodstream, and lymphatic system. B-CLL is the most common type of leukemia in adults in Western countries.

Etiology

The exact cause of B-CLL is unknown, but several risk factors have been identified. These include advanced age, male gender, Caucasian ethnicity, and a family history of B-CLL or other hematologic malignancies. Exposure to certain chemicals and radiation may also increase the risk of developing B-CLL.

Pathophysiology

In B-CLL, the DNA of a B cell becomes damaged, causing the cell to grow and divide uncontrollably. These abnormal B cells accumulate in the bone marrow and blood, crowding out healthy blood cells. Over time, this can lead to anemia, infections, and bleeding disorders.

Clinical Features

Many people with B-CLL have no symptoms at diagnosis and the disease is often discovered incidentally during routine blood tests. When symptoms do occur, they may include fatigue, weight loss, frequent infections, enlarged lymph nodes, and discomfort under the left lower ribs caused by an enlarged spleen.

Diagnosis

The diagnosis of B-CLL is based on the findings of a complete blood count (CBC) and examination of the blood under a microscope. Additional tests, such as flow cytometry, cytogenetics, and molecular genetics, may be used to confirm the diagnosis and determine the prognosis.

Treatment

The treatment of B-CLL depends on the stage of the disease and the patient's overall health. Options may include watchful waiting, chemotherapy, immunotherapy, targeted therapy, and stem cell transplantation.

Prognosis

The prognosis of B-CLL varies widely, depending on the stage of the disease and the presence of certain genetic abnormalities. Some people with B-CLL live for many years without requiring treatment, while others may have a more aggressive course of disease.

See Also

• Leukemia
• B cells
• Cancer
• Chemotherapy
• Immunotherapy