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Chronic lymphocytic leukemia: Why is it sometimes called the "silent disease"?
Chronic lymphocytic leukemia (CLL) is a cancer that affects lymphocytes, which are white blood cells that come from the bone marrow. Surprisingly, early-stage CLL often shows no symptoms, leading to it being called the “silent disease.” As the disease progresses, patients may experience painless swollen lymph nodes, fatigue, fever, night sweats, or unexplained weight loss. The disease often progressively worsens over several years, posing many unnecessary health risks.
Many patients may live for years without knowing it until they are diagnosed with CLL.
Causes and risk factors of CLL
Risk factors for chronic lymphocytic leukemia include family history, exposure to certain pesticides and chemicals (such as Agent Orange), sun exposure, and certain viral infections. According to statistics, about 10% of CLL patients have a family history of the disease. Additionally, CLL most commonly affects adults over the age of 65, and is nearly twice as common in men as in women.
Symptoms and diagnosis
Many people with CLL are diagnosed after an unexpectedly high white blood cell count is discovered during a routine blood test. Most of the time these patients do not experience any symptoms, and only a few develop swollen lymph nodes. Sometimes, cancer cells overwhelm the bone marrow, causing a low number of red blood cells, white blood cells, or platelets. These symptoms include fever, night sweats, fatigue and weight loss. Diagnosis of CLL usually relies on detailed analysis of blood samples and flow cytometry testing.
When CLL is asymptomatic in its early stages, careful observation is often more effective than early intervention.
Comorbidities and disease course
Chronic lymphocytic leukemia can cause many comorbidities, such as low antibody levels in the blood, febrile autoimmune hemolytic anemia, and bone marrow failure. When CLL reaches an advanced stage, it may also develop "Richter transformation," a condition that transforms into a more aggressive form of lymphoma. Even before these changes occur, patients may be at risk for other, more aggressive diseases, such as lung cancer and cutaneous melanoma.
Treatment options
Currently, treatment for CLL focuses on disease control rather than cure. For early asymptomatic patients, monitoring changes in symptoms is an ideal treatment strategy. For patients who are already symptomatic, treatment options may include chemotherapy, immunotherapy, or chemoimmunotherapy. Treatment options vary depending on the patient's age and physical condition, making CLL treatment more personalized.
With the emergence of new targeted therapies (such as BTK inhibitors), the survival rate of CLL patients has improved significantly.
Prognosis and quality of life
According to statistics, the five-year survival rate of CLL patients is approximately 83%. Although the disease is considered incurable, many patients are able to live normal and fulfilling lives with appropriate treatment. Therefore, early diagnosis and timely intervention are crucial to improve the quality of life of CLL patients.
Conclusion
Chronic lymphocytic leukemia is often regarded as a "silent disease" due to its unique clinical features and relatively slow progression. This allows patients to sometimes live quietly for years with no obvious symptoms, but allows hidden health risks to persist. Should we be more vigilant about our health today in order to detect this silent but potentially dangerous disease early?
