Fludara® Information for Patients

CHRONIC LYMPHOCYTIC LEUKEMIA (CLL)

Blood and its role in CLL

Blood basics

Your blood does 2 very important things: it carries oxygen and nutrients to every cell in your body and it carries away waste products which are eliminated from your body. Blood consists of 3 cell types, each of which perform an important function:

Red blood cells carry oxygen to the cells. The part of the red blood cell that carries the oxygen is called hemoglobin.
Platelets are cells that form clots to control bleeding.
White blood cells are part of the immune system and help the body fight infection. Another name for white blood cells is leukocytes.

Red blood cells, white blood cells, and platelets are all made in your bone marrow.

About healthy leukocytes

White blood cells help protect your body from infections. Healthy white blood cells fight germs, such as bacteria and viruses that can invade your body and cause infections. When germs get into your body, your immune system makes more white blood cells to fight the infection.

There are 3 main types of white blood cells:

Granulocytes attack and destroy germs. The most common type of granulocyte is called a neutrophil.
Monocytes break down and remove damaged or dead blood cells and germs.
Lymphocytes include B cells and T cells. B cells produce antibodies, which help your immune system target and destroy germs. T cells help fight viral infections.

About leukemia

Leukemia is a cancer of the white blood cells. It causes your body to make white blood cells that are abnormal and cannot fight infection. These abnormal cells begin to take the place of the normal, healthy cells in your bone marrow. The “crowding out” of healthy red and white blood cells and platelets by leukemia cells can lead to infections, feeling tired, and bruising easily.

Leukemia can be either acute or chronic.

Acute leukemia develops rapidly and progresses. Both adults and children can develop acute leukemia.
Chronic leukemia may take several years to develop and more often affects adults.

Leukemia is classified by the type of blood cell that it affects. Lymphocytic leukemia is a disease of B cells and T cells. It most often affects B cells and rarely affects T cells.

Facts about CLL

CLL is a common adult leukemia in the United States.¹ The American Cancer Society estimates that 8,100 people will be diagnosed with CLL in 2001.² CLL occurs more often in men than in women and usually affects people over 50 years of age. The exact cause of CLL is not known.

CLL develops slowly and can last for years. In its early stages it often has no signs or symptoms. Sometimes CLL is found “by chance” during a routine blood test. Other times people have 1 or more of the following signs and symptoms:

Fatigue (feeling tired)
Fever
Sudden weight loss
Night sweats
More colds or infections than usual
Swollen glands in the neck, armpits, or groin
Feeling “full” on the left side of the belly (caused by a swollen spleen)

Treatment

CLL is often treated with chemotherapy. If you are in an early stage of CLL, your doctor may suggest waiting to begin treatment until you have symptoms or your blood tests show that your disease has progressed. Your doctor will discuss with you if early treatment of your CLL can benefit you.

Doctors may start treatment of CLL with a type of chemotherapy called an alkylating agent. Sometimes several of these agents are used together. Or your doctor may choose a different kind of chemotherapy that may help you.

Remission

When your CLL responds to treatment with chemotherapy, your disease goes into remission. When you are in remission, your blood counts may return to normal and you start to feel better. Even a partial remission may improve your quality of life.

Relapse

Over time, however, many people with CLL who are treated with alkylating agents experience a relapse. This means that their disease returns. When CLL returns, it may not respond to the chemotherapy that was first used to treat it. This is called refractory disease. When CLL is refractory, a different chemotherapy will be needed to fight it.

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