Conditions & Treatments

Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is a cancer of the blood in which too many lymphocytes, a type of white blood cell, are produced by the bone marrow and by organs of the lymph system.

Chronic Lymphocytic Leukemia

What is chronic lymphocytic leukemia?

Chronic lymphocytic leukemia (CLL) is a cancer of the blood in which too many lymphocytes, a type of white blood cell, are produced by the bone marrow and organs of the lymph system.

Normally, most lymphocytes fight infection by making antibodies that attack harmful elements. But, in CLL, the cells are immature and overabundant. They crowd out other blood cells, and may collect in the blood, bone marrow, and lymph tissue. CLL is a slowly progressing disease.

According to the American Cancer Society, about 15,700 cases of CLL are expected to be diagnosed in 2013, and about 4,600 people will die of CLL.

What are the symptoms of chronic lymphocytic leukemia?

Early in the disease, there may be no noticeable symptoms, and many cases are diagnosed on routine blood tests. The following are the most common symptoms of chronic lymphocytic leukemia. However, each individual may experience symptoms differently. Symptoms may include:

  • Persistent weakness or fatigue

  • Swollen lymph nodes

  • Enlarged spleen, which can cause loss of appetite

  • Enlarged liver

  • Fever

  • Night sweats

  • Weight loss

  • Frequent infections

  • Easy bruising or bleeding

The symptoms of chronic lymphocytic leukemia may resemble other blood disorders or medical problems. Always consult your health care provider for a diagnosis.

How is chronic lymphocytic leukemia diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for chronic lymphocytic leukemia may include the following:

  • Blood tests and other evaluation procedures

  • Bone marrow aspiration and/or biopsy. A procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.

  • Spinal tap/lumbar puncture. A special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebrospinal fluid (CSF) can be removed and sent for testing to determine if there is an infection, leukemia cells in the CSF, or other problems. CSF is the fluid that bathes the brain and spinal cord. This test isn't usually needed for CLL unless your doctor suspects a problem in the brain or spinal cord.

Treatment for chronic lymphocytic leukemia

Specific treatment for chronic lymphocytic leukemia will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Other traits of the disease, such as chromosome changes in the leukemia cells

  • Whether or not you are having symptoms

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment may include:

  • Watchful waiting. Close monitoring of the disease and not treating it unless it begins to grow quickly or cause symptoms. 

  • Chemotherapy

  • Radiation therapy

  • Monoclonal antibodies, such as Rituxan, Arzerra, or Campath, that provide targeted therapy

  • Treatment for complications, such as infection or anemia

  • Leukapheresis. A procedure to remove excess lymphocytes from the body.

  • Bone marrow or peripheral blood stem cell transplantation

  • Splenectomy. Surgery to remove the spleen.

Treatment Programs


Massachusetts General Hospital understands that a variety of factors influence patients' health care decisions. That's just one reason why we're dedicated to ensuring patients understand their diagnosis and treatment options. Because a single option might not serve all patients, we offer a wide range of coordinated treatments and related services across the hospital. Patients should consult with their primary care doctor or other qualified health care provider for medical advice and diagnosis information.

Select a treatment program for more information:



Cancer Center

  • Lymphoma
    The Center for Lymphoma integrates the best in clinical care, research and support services to provide comprehensive, compassionate care for patients diagnosed with Non-Hodgkin and Hodgkin lymphomas.
Imaging

  • Cancer Imaging and Intervention
    The Cancer Imaging and Intervention Program at Massachusetts General Hospital Imaging combines leading-edge technology and the expertise of specialty-trained radiologists to provide comprehensive cancer detection and monitoring, plus image-guided treatments for specific types of cancer.
MassGeneral Hospital for Children

  • Psychology Assessment Center
    The pediatric neuropsychology specialists at Massachusetts General Hospital’s Psychology Assessment Center provide neuropsychological assessments to aid in the diagnosis and treatment of neurological, medical, genetic and developmental disorders.
Department of Dermatology

  • High Risk Skin Cancer Clinic (Non-Melanoma)
    The High Risk Skin Cancer Clinic (HRSCC) at Massachusetts General Hospital provides comprehensive care for those patients at greater risk for non-melanoma skin cancer, specifically solid organ transplant recipients and patients with certain types of leukemia.
Benson Henry Institute for Mind Body Medicine

  • Consultation
    Come in for a consultation, leave with a comprehensive mind body treatment plan that addresses your stress-related medical condition.
  • Cancer Program
    Designed to supplement the medical treatment of cancer patients by giving them tools to cope with the stress of their illness, make informed choices about treatment, and maintain hope.

The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.

Innovative care at the Cancer Center

Learn more about the latest treatment options for this condition at the Cancer Center