Chronic Lymphocytic Leukemia (CLL)

Chronic lymphocytic leukemia (CLL) is a clonal lymphocytic neoplasm; lymphocytes accumulate in marrow, lymph nodes, blood, spleen, liver, and other organs. >95% of CLL is B-cell clonal proliferation (B-CLL); <5% are T-cell phenotype (T-CLL).

Common Symptoms

Bleeding tendency; hepatosplenomegaly; diarrhea; abdominal distension; night sweats; fatigue; low fever; hepatomegaly; proteinuria

Causes and Pathogenesis

(1) Etiology: unknown; retroviruses/ionizing radiation not proven; genetic (racial/familial) + sex factors. Family history = 3x risk; autoimmune disease more common in relatives. ~50% have chromosomal abnormalities (chr12/4; -8, i(7), i(2p), t(13;21), 18, 6q-, 14q-, -X); early 20%, late 70%; involves Ig genes (chr14 heavy-chain) or oncogenes (c-ras-Harvey chr12, c-ras-Kirsten chr11). (2) Mechanism: environmental factors not linked. (a) Genetics: high in Whites/Blacks, low in Asians; family B-CLL clustering; HLA not linked. (b) Chromosomes: ~50% clonal abnormalities. 13q deletion (~50%: 13q12.3 BRCA2; 13q14.3 RB-1/DBM/LEV). Trisomy 12 (progression/Richter). 11q rearrangement/deletion (10-20%; young, aggressive; MEN-1/RDX/AIM/p53). 6q abnormalities (6q21-24; TNF-alpha/LY-alpha). 14q translocations (rare in CLL; t(11;14) mantle; t(14;18) follicular). (c) Special genes: p53 (17p13.1; 10-15% deletion/mutation; aggressive, Richter/B-PLL). MDR-1 (7q21.1; 40%). bcl-2 (18q21; overexpression; hypomethylation; apoptosis resistance). (d) Cytokines: TNF-alpha/TGF-beta/IL-7/IL-5/IL-2 stimulate CLL growth, suppress normal hematopoiesis. Cell kinetics: most cells in G0; high bcl-2/low bax → apoptosis block → mature small lymphocyte accumulation.

Treatment

Drug, supportive therapy

Preventive Measures

(1) Optimism. (2) Rest/work balance; regular habits. (3) High-fiber/fresh produce; balanced protein/carbs/fat/vitamins/minerals/fiber.

Department to Visit

It is recommended to visit the Hematology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.