- In the early stages, the condition is asymptomatic, the only feature being a peripheral lymphocytosis.
- CLL usually progresses slowly with increasing lymphocytosis, lymphadenopathy, splenomegaly, hepatomegaly and bone marrow involvement with cytopenias. Systemic symptoms (fever, weight loss and night sweats) are rare.
- Other complications of CLL include autoimmune haemolytic anaemia, immune thrombocytopenia and hypogammaglobulinaemia with recurrent infections and herpes zoster. CLL can also transform to high-grade lymphoma (Richter’s transformation).
- Due to the increased risk of infections prompt antibiotic therapy should be offered.
- The following are considered as one area of organ enlargement each: neck, axillae, groin, spleen, liver e.g. bilateral cervical nodes = one site
- Lymphadenopathy in CLL is usually bilateral, soft, mobile and painless. Unilateral lymphadenopathy is unusual in CLL and may require further investigation.
Stage Definition Prognosis (median survival – years)
0-2 areas of organ enlargement
3-5 areas of organ enlargement
Hb <100 g/L or platelets <100x109/L
(unless due to immune mechanisms)