Types of Chronic Lymphocytic Leukemia (CLL)
According to the presence of the proteins ZAP-70 and CD38 chronic lymphocytic leukemia can be classified into two:
- When the amount of these proteins in the CLL cells is low it grows slowly and it is after a long time that patients may require treatments.
- On the contrary, the high amount of these proteins in CLL makes it develop and spread faster leading to a serious disease.
Symptoms of Chronic Lymphocytic Leukemia(CLL)
- Swollen lymph nodes in the neck, stomach, underarm or groin.
- Feelings of extreme exhaustion.
- Pain or feeling full below the ribs.
- Weight loss
Risks of Chronic Lymphocytic Leukemia
- Exposure to chemicals for a long period of time, for instance, pesticides.
- Medical history of the patient’s family, especially siblings, parents and children
- Gender as it is more common in men that women
Diagnosis of Chronic Lymphocytic Leukemia
- Physical examination and history to observe the external symptoms of CLL and whether it is hereditary or not.
- Complete blood count (CBC) with differential to check the count of red blood cells, white blood cells, platelets and the amount of hemoglobin.
- Immunophenotyping is a laboratory test performed to observe the antigens on the surface of blood and bone marrow cells.
- Fluorescence In Situ Hybridization (FISH) used to look at the chromosomes or genes present in the cells or tissues.
- Flow cytometry is a laboratory test used to check the number cells in a sample.
- Ig VH gene mutation test performed on sample bone marrow to check for Ig VH gene mutation.
- Bone marrow biopsy performed to look for abnormal cells.
- Chest X-ray, CT Scan, MRI Scan are performed to check the spread of cancer in the body.
Treatment of Chronic Lymphocytic Leukemia
The treatment options for chronic lymphocytic leukemia are:
- Chemotherapy- Chemotherapy drugs are given either in the form of tablets or injected into the veins or the muscles. The common chemotherapy drugs for chronic lymphocytic leukemia are purine analogs, alkylating agents, corticosteroids, doxorubicin, methotrexate, oxaliplatin and others.
- Monoclonal Antibodies- Monoclonal antibodies can be defined as man-made immune system proteins or antibodies that attach to the proteins on the surface of the leukemia cells and assist the immune system to react and kill the leukemia cells.
- Targeted Therapy- In targeted therapy, such drugs are provided to the patients that identify and kill only the leukemia cells while not affecting the other healthy ones.
- Stem Cell Transplant- High dose of chemotherapy is often followed by stem cell transplants. The stem cells are either obtained from blood, bone marrow or from umbilical cord blood. There are two types of stem cell transplant: allogenic (from a donor) and autologous (from the patient himself). In case of chronic lymphocytic leukemia, allogenic stem cell transplant is mostly performed since there is always a risk of acquiring leukemic cells during the harvest.
- Leukapheresis- In this procedure the blood of the patient is made to pass through a special machine that gets rid of white blood cells and leukemic cells. By the end of the procedure the blood is returned to the patient’s body with only red blood cells and plasma. It helps to cut down the leukemia cells faster.
Factors affecting the cost of Chronic Lymphocytic Leukemia Treatment
The following factors affect the treatment cost of Chronic Lymphocytic Leukemia:
- The hospital, the patient chooses
- Room– Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate, and room service)
- The type of chronic lymphocytic leukemia suggested by the hematologist
- Fee for the team of doctors.
- Standard test and diagnostic procedures
- Cost of the follow –up care required after the procedure