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CLL (chronic lymphocytic leukemia) related complications: Is it time to treat?
Mar 13, 2002

I'm writting on behalf of a close relative who suffers from chronic lymphcytic leukemia (CLL) for 6 years now. He is 59 and always had relatively stable white count (10.000 leukocytes, with 60-70% lymphocytes), thus making a non-agressive form of CLL. Lately his Hgb and Hct has fallen a little to 11 Hbg and 35 Hct. There is evidence of some involvment of his spleen. The problem is he has a very bulky adenopathy, especially in the cervical area, also axillar, inguinal. In the last weeks, the cervical adenopathy has produced some compression on the airways of the neck, making it very difficult to sleep at night. He had no prior treatment for his disease. My question is what do you suggest in this case: removal of some the lymph nodes that are producing the compression, or starting a form of treatment ? Is it local radiotherapy a solution ? Thank you in advance for your answer,

Response from Dr. Dezube

Your relative's sitiuation merits chemotherapy, plain and simple! When these tumors cause complications such as airway obstruction, they must be treated. They respond very very well to chemotherapy so that there is really no reason to surgically remove them. Since chronic lymphocytic leukemia is a systemic disease (i.e. typically involves many portions of the body), there is no reason to just treat one area with radiation. There are several very good treatments for CLL. The response rates are quite high.

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