সংজ্ঞা
Chronic lymphocytic leukemia (CLL) is a cancer of the blood and bone marrow. Lymphocytes are a type of white blood cell. With CLL, the bone marrow makes too many of these cells. CLL begins in mature lymphocytes. It may be slow growing for many years. You may have little or no trouble. It may also progress to acute lymphoblastic leukemia (ALL), a more aggressive form of leukemia. Some forms of CLL may be more serious. This is because leukemia involves the cells of the immune system. These cells are needed to resist infection.
Cancer occurs when cells in the body become abnormal. They divide without control or order. Leukemia is cancer of the white blood cells and their parent cells. Leukemia cells do not function normally. They cannot do what normal blood cells do. In this case, they cannot fight infections. This means that the person is more likely to become infected with viruses or bacteria. The cancerous cells also overgrow the অস্থি মজ্জা. This forces other normal components, like platelets, out. Platelets are needed to help the blood clot. As a result, people with leukemia may bleed more easily.
CLL can also be associated with the presence of chronic lymphocytic lymphoma. This is a small cell non-Hodgkin’s lymphoma. The abnormal cells in both cases may come from the same parent cell source. As a result, one of the signs of CLL may be swelling in the lymph nodes.
কারণসমূহ
The exact cause of CLL is unknown. Changes in chromosomes that occur during life have been associated with CLL. It is also associated with exposure to radiation and to toxic chemicals such as:
- Benzene (common in agriculture, paint manufacture, and dye manufacture)
- Agent Orange (an herbicide used in the Vietnam war)
ঝুঁকির কারণ
The following factors increase your chance of developing CLL:
- Age: Middle age or older
- সেক্স পুরুষ
- জাতি: সাদা
- A family history of CLL or cancer of the lymphatic system
- Having relatives who are Russian Jews or Eastern European Jews
- Exposure to Agent Orange
লক্ষণ
উপসর্গ অন্তর্ভুক্ত:
- Painless swelling in the neck, underarms, stomach, or groin
- ক্লান্তি
- ফ্যাকাশেতা (অ্যানিমিয়ার লক্ষণ)
- পাঁজরের নিচে ব্যথা বা পূর্ণতার অনুভূতি
- জ্বর
- সংক্রমণ
- ব্যাখ্যাতীত ওজন হ্রাস
- Reduced exercise tolerance
- হাড়ের ব্যথা
- Enlargement of liver and spleen
রোগ নির্ণয়
Your doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor may also check for swelling of the liver, spleen, or lymph nodes. The nodes may be in the armpits, groin, or neck. You will likely be referred to an oncologist. This is a doctor who specializes in treating cancer.
- You may need to have tests of your bodily fluid. This can be done with:
- রক্ত পরীক্ষা
- অস্থি মজ্জার উচ্চাকাঙ্ক্ষা
- অস্থি মজ্জা বায়োপসি
- মেরুদণ্ডের আংটা
- Routine microscopic exam
- Bone, blood marrow, lymph node tissue, or cerebrospinal fluid tests
- Cytogenetic analysis
- আপনার শারীরিক গঠনের ছবি তোলার প্রয়োজন হতে পারে। এটি দিয়ে করা যেতে পারে:
- বুকের এক্স - রে
- সিটি স্ক্যান
- এম.আর. আই স্ক্যান
- Gallium scan and bone scan
- আল্ট্রাসাউন্ড
চিকিৎসা
আপনার জন্য সেরা পরিকল্পনা সম্পর্কে আপনার ডাক্তারের সাথে কথা বলুন। চিকিত্সার বিকল্পগুলির মধ্যে রয়েছে:
সতর্ক প্রতীক্ষা
A doctor monitors the progress of the disease. Other treatment is not started until symptoms appear to change and become a problem. During this time, other problems, including infection, can be treated. Watchful waiting is often used in low-risk CLL. Some patients may go for many years before more aggressive treatment is needed.
বিকিরণ থেরাপির
This therapy is the use of radiation to kill cancer cells and shrink tumors. For CLL, external radiation therapy is used. The radiation is directed at the tumor from outside the body. This treatment is used to treat the brain and spinal cord when indicated. It is also used to treat lymph node issues.
কেমোথেরাপি
Chemotherapy is the use of drugs to kill cancer cells. It may be given by pill, injection, or via a catheter. The drugs enter the bloodstream and travel through the body. It kills mostly cancer cells, but also some healthy cells.
সার্জারি
A splenectomy may be done. This is a surgery to remove the spleen.
Monoclonal Antibody Therapy
This therapy uses antibodies made in a lab. The antibodies help to identify substances on cancer cells or on normal cells that may help cancer grow. The antibodies attach to these substances. This kills the cancer cells, blocking their growth, or preventing them from spreading.
স্টেম সেল ট্রান্সপ্ল্যান্টের সাথে কেমোথেরাপি
Chemotherapy with stem cell transplant as a treatment for CLL is still being tested in clinical trials. In this treatment, chemotherapy is followed by a transplantation of immature blood cells called stem cells. The stem cells replace blood-forming cells destroyed by ক্যান্সারের চিকিৎসা. Stem cells are removed from the blood or bone marrow of the patient or donor, and infused into the patient.
পার্শ্ব প্রতিক্রিয়া চিকিত্সা
Patients will suffer side effects not only from the leukemia, but from therapy. These include:
- A reduction in red blood cells that can lead to anemia
- Reduced numbers of platelets that assist in blood clotting—called thrombocytopenia
- শ্বেত রক্ত কণিকার সংখ্যা হ্রাস পায় যা সংক্রমণের বিরুদ্ধে লড়াই করে
Anemia may lead to fatigue. If severe enough, it can complicate respiratory or cardiac disease. Thrombocytopenia may lead to bleeding and bruising. Decreased numbers of white blood cells leave a patient more prone to infection.
Drugs are available to increase production of normal blood cells. When counts are very low, your doctor may recommend blood transfusions. You may also need to change your daily activities to reduce the chance of fatigue, bleeding, or infection.
প্রতিরোধ
There are no guidelines for preventing CLL.