Symptoms and Diagnosis of Chronic Lymphomatic Leukemia (CLL): and Non-Hodgkins Lymphoma (NHL)

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Remember, everyone is different and your symptoms and experience may not match those described below. If you have any further questions, be sure to ask your medical professional.

What is CLL?

Lymphocytic leukaemias (also known as lymphoid or lymphoblastic leukaemia) develop in bone marrow cells that will become lymphocytes. These cells are also the ones affected in lymphoma, but the key difference is that, in lymphocytic leukaemias, the cancer cells are mainly in the bone marrow and blood, whereas in lymphoma, the cells tend to collect in lymph nodes and other tissues.

There are generally two types of CLL:

  • One grows very slowly and may not require treatment for a long time
  • One grows more quickly and is more serious.

Symptoms of Chronic Lymphocytic Leukaemia

Many people with Chronic Lymphocytic Leukaemia don’t display any symptoms. The disease is often picked up during a routine blood test.

Even when symptoms are present, they may be vague and similar to other more common illnesses. These symptoms may not necessarily indicate that you have chronic lymphocytic leukaemia. This is the reason to see your doctor for further investigation.

Some common symptoms include:

  • Feeling weak or tired
  • Weight loss
  • High temperature
  • Night sweats
  • Enlarged lymph nodes (felt as lumps in the neck or groin)
  • Frequent infections
  • A sensation of being full after a small meal or stomach pains
  • A tendency to bruise or bleed easily (e.g. bleeding gums during tooth brushing).

A Diagnosis of CLL

A diagnosis of blood cancer usually begins with a visit to your GP to check out your symptoms. If your doctor suspects leukaemia, they may order the following tests:

  • Blood tests: This will show whether you have more lymphocytes than normal. This is one of the signs of chronic lymphocytic leukaemia. You may also have low levels of red blood cells and platelets because the leukaemia cells are disrupting the normal process of blood cell formation.
  • Flow cytometry: Flow cytometry is a process used to identify whether the lymphocytes are cancer cells.
  • Imaging scans, such as a CT scan or MRI
  • Biopsy
  • Imaging tests, such as a CT scan or MRI
  • Heart and lung function tests

biopsy

What is Non-Hodgkin’s Lymphoma?

About 85% of all lymphomas are Non-Hodgkin’s Lymphoma (NHL).1 NHL affects the lymphocytes in lymph nodes and other tissues involved in the lymph system, including the spleen and bone marrow. There are two main types of lymphocytes:

T-lymphocytes (called T because they mature in the thymus gland)

B-lymphocytes (called B because they mature in the bone marrow).

NHL may affect T-cells or B-cells, but most types of NHL involve B-lymphocytes. They include subtypes called diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, mantle cell lymphoma, marginal zone B-cell lymphomas, Burkitt lymphoma, among others. The type of NHL you have may affect the types of treatment offered to you.

Symptoms of NHL

Non-Hodgkin’s lymphoma can cause a range of different symptoms, depending on which parts of the lymphatic system are affected. These symptoms may not necessarily indicate that you have blood cancer. This is the reason to see your doctor for further investigation.

Symptoms may include:

  • Enlarged lymph nodes – also called ‘swollen glands’
  • Swollen abdomen (belly)
  • Shortness of breath/cough
  • Night sweats
  • Unexplained weight loss
  • Fatigue (tiredness)
  • Frequent infections
  • A sensation of being full after a small meal or stomach pains
  • Chest pain or pressure
  • High temperature
  • Unexplained weight loss
  • A tendency to bruise or bleed easily (e.g. bleeding gums during tooth brushing).

A Diagnosis of NHL

Many of the symptoms of Non-Hodgkin’s Lymphoma are similar to an infection.

It’s common for a doctor to initially treat for an infection and to then proceed with further testing if the enlarged lymph nodes do not shrink or if they continue to grow.

Common areas for enlarged lymph nodes: When these lymph nodes close to the skin are enlarged, you and your doctor may be able to see and feel them as lumps

lymph nodes

Common tests include:

Biopsy: This involves removing a sample of the lymph node so that it can be analysed for cancer cells. A biopsy can either be done during a small operation or via a fine needle.

Bone Marrow Biopsy: This is sometimes done once non-Hodgkin’s lymphoma has been diagnosed to determine whether the bone marrow is affected by the cancer.

Imaging Tests, such as a CT scan or MRI: These are done to see whether the cancer has spread or to determine whether other symptoms, such as abdominal pain, are caused by the cancer.

Heart and Lung Function Tests: Some treatments for non-Hodgkin’s lymphoma can have a negative effect on the heart and lungs so it’s important to make sure these organs are healthy enough if you need certain medicines.


References:

  1. Ministry of Health. 2014. Cancer: New registrations and deaths 2011. Wellington: Ministry of Health. Available from: http://www.health.govt.nz/system/files/documents/publications/cancer-new-registrations-deaths-2011-v4sept14.pdf. Accessed April 2015.
  2. Ministry of Health. 2014. Selected Cancers, 2011, 2012 & 2013. Wellington: Ministry of Health. Available from: http://www.health.govt.nz/publication/selected-cancers-2011-2012-2013. Accessed April 2015.