Large granular lymphocyte leukemia

Overview

A form of leukemia characterized by an increased number of circulating granular lymphocytes.

Symptoms

  • Neutropenia
  • Fever
  • Recurring infections
  • Fatigue
  • Night sweats
  • Weight loss
  • Asymptomatic in early stages
  • Lymphadenopathy
  • Enlarged liver
  • Enlarged spleen
  • Lymphocytosis
  • Asymptomatic in early stages
  • Neutropenia
  • Recurring infections
  • Night sweats
  • Anemia
  • Rheumatoid arthritis

Causes

Although the cause of CLL is unknown, researchers suspect hereditary factors (higher incidence has been recorded within families), still-undefined chromosome abnormalities, and certain immunologic defects (such as ataxia-telangiectasia or acquired agammaglobulinemia). The disease doesn't seem to be associated with radiation exposure, carcinogenic chemicals, or viruses. Approximately 2 out of every 100,000 people develop CLL annually, with 90% of cases found in people who are older than age 50. Many cases go undetected by routine blood tests in people who are asymptomatic. The disease is common in Jewish people of Russian or Eastern European descent, and is uncommon in Asia.

Diagnosis

* Colon & Rectal Cancer: Home Testing o Home Colorectal Cancer Tests o Home Fecal Occult Bleeding Tests

Treatment

Systemic chemotherapy includes alkylating agents — usually chlorambucil, cyclophosphamide, vincristine, or fludarabine (singly or in combination) — and steroids (prednisone) when autoimmune hemolytic anemia or thrombocytopenia occurs. An advance in the treatment of CLL has been the emergence of the humanized monoclonal antibodies rituximab and alemtuzumab. Alemtuzumab acts as an antibody against the surface of CLL cells and is used when fludarabine fails. Rituximab, a monoclonal antibody, acts similiarly to alemtuzumab; studies are ongoing. When chronic lymphocytic leukemia causes obstruction or organ impairment or enlargement, local radiation treatment can be used to reduce organ size. Allopurinol can be given to prevent hyperuricemia, a relatively uncommon finding. Prognosis is poor if anemia, thrombocytopenia, neutropenia, bulky lymphadenopathy, and severe lymphocytosis are present.