Chronic Lymphocytic Leukemia (CLL)
In this article, we have covered the following:
- Best Hospitals in India for treatment of CLL
- Best Hemato Oncologists for CLL treatment
- Cost of CLL treatment in India
- Understanding CLL, Causative factors
Best Doctors and Hospitals in India for treatment of CLL
Following is a list of the most reputed specialists in India for the treatment of Chronic Lymphocytic Leukemia.
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Cost of CLL treatment
Unfortunately, we are not able to share the cost of this treatment as we are still awaiting response from few hospitals before publishing the cost. However, you may share your medical reports and we will share the cost of treatment from the hospital recommended for you.
Chronic Lymphocytic Leukemia (CLL) is a blood cancer type in which the bone marrow makes too many lymphocytes (a kind of white blood cell). It mostly affects men above 55 years of age. Though the disease is rarely curable, but patients can live for many years through effective treatment measures.
Cause of CLL
As observed in most cancers, there is no certain cause of chronic lymphocytic leukemia. It is suspected to be an inherited disorder as rare instances of family history of CLL have been reported.
CLL is found to be extremely rare in Asian natives and higher among whites than blacks.
Signs and symptoms of CLL
Usually patients with CLL have no symptoms. About 25-50% of patients are asymptomatic at time of diagnosis. The disease is mostly discovered incidentally after a blood cell count is done for some other reason.
It is advisable not to ignore the below symptoms, as these may be signs of CLL:
- Swollen lymph nodes in your neck, armpits, stomach, or groin
- Shortness of breath, extreme fatigue
- Loss of appetite and weight
- Pain or fullness in stomach
- Excessive sweating during nights longer than one month
- Fever longer than two weeks and infections
- Anemia or thrombocytopenia
- Progressive or symptomatic enlargement of the spleen
- Progressive lymphocytosis (increase in lymphocytes count in blood)
Investigations for CLL
- CBC with peripheral smear
- Bone marrow aspiration and biopsy with flow cytometry (not required in all cases of CLL)
- Ultrasound whole abdomen
- Chromosomal test – Additional molecular testing that may help predict prognosis or clinical course
- Lymph node biopsy – If lymph nodes enlarge rapidly, the biopsy is done to assess the possibility of change into a high-grade lymphoma.
Staging of CLL
As per the Rai-Sawitsky staging system CLL patients are categorized as below:
- Low risk (stage 0) – Lymphocytosis in the blood and marrow only
- Intermediate risk (stages I and II) – Lymphocytosis with enlarged nodes in any site or splenomegaly (spleen enlargement) or hepatomegaly (enlarged liver)
- High risk (stages III and IV) – Lymphocytosis with disease-related anemia (hemoglobin < 11 g/dL) or thrombocytopenia (platelets < 100 x 10 9/L)
Aggressive forms of CLL
Prolymphocytic Leukemia (PLL) and Hairy Cell Leukemia (HCL) are two types of aggressive chronic B-cell leukemia. B-cells are a type of lymphocyte that makes antibodies for the immune system.
Prolymphocytic Leukemia (PLL)
Prolymphocytic Leukemia (PLL) involves presence of large number of immature lymphocytes in the blood. It may occur on its own, along with CLL, or CLL may transform into PLL. PLL is more aggressive than CLL.
Hairy Cell Leukemia (HCL)
Hairy Cell Leukemia (HCL) is a slow-growing form of CLL. It is known as hairy cell because the abnormal lymphocytes have hair-like projections, which multiply in the bone marrow, blood, and spleen. These abnormal lymphocytes fail to fight diseases and infection. Eventually, these overgrow in number than the healthy cells.
Management of CLL
Early stages of CLL are not treated as the treatment (chemotherapy) has failed to show benefit. The treatment starts only when your doctor notices rapid progression of disease such as increase in lymphocytes count, decrease in RBCs count, or increase in lymph node swelling. The five-year survival rate of CLL is 75%.
The CLL treatment involves:
Chemotherapy: Combination regimens of chemotherapy have shown improved response rates
Bone Marrow Transplant: Allogenic bone marrow (stem cell) transplant, in which matching donor is required, is the only known curative therapy for CLL.
Note (for foreign patients):
Besides South Asian countries (Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, Pakistan, Sri Lanka), every year, India gets thousands of medical tourists from African countries- Nigeria, Kenya, Ethiopia, Sudan, Uganda, Ghana, Somalia,Gambia etc and Middle Eastern countries like Iraq, Iran, Saudi Arabia, Oman, UAE, Yemen etc. Hence, if you are a citizen of any of these countries, there is good likelihood that you will be meeting some fellow citizens or same language speakers in the major hospitals in India. Almost all the top hospitals have translators for people of these region. Our patient support team is also well placed to assist you.