Chronic Lymphocytic Leukemia: Diagnosis

Chronic Lymphocytic Leukemia (CLL)/ Small Lymphocytic Lymphoma (SLL) is diagnosed through a blood test and sometimes through biopsies from a lymph node and/or the bone marrow.

A blood test allows physicians to see if there is a higher white blood cell count than normal, or if there are any other blood anomalies. What is called a “complete blood count,” or CBC, is performed. A CBC measures the following:

  • The number of red blood cells (RBCs)
  • The total amount of hemoglobin (a protein found in the RBCs)
  • The number of white blood cells (WBCs)
  • The total number of platelets (necessary for clotting)
  • Numbers of lymphocytes and other types of cells, in a differential count of a blood smear

The differential cell count on a blood smear delineates the proportion of the different types of white cells. It also allows observation of red blood cells and platelets. When CLL/SLL is present, future cell counts will show changes, such as an increase in the proportion of lymphocytes in circulation. The pattern of the changes, total counts, or proportions, will help to determine if the disease is progressing.

Many patients do not experience symptoms, and the disease may be found through a routine medical exam, leading to a diagnosis of CLL/SLL, often through “routine blood work.” People diagnosed with CLL/SLL may remain symptom-free for quite some time.

Symptoms and Signs

Some findings associated with a diagnosis of CLL/SLL are listed below.

  • Enlarged lymph nodes or spleen
  • Fatigue shortness of breath, and anemia (low red cell counts)
  • Abnormal bruising (usually occurs late in the disease)
  • Sweating, excessive night sweats
  • Loss of appetite, filling up easily, weight loss
  • Frequent infections of the skin, lungs, kidneys or other sites