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Chronic leukaemia (CML & CLL)

Leukaemia chronica (myeloides et lymphocytica) · Chronická leukémie (CML a CLL)

What it is

Mature-looking white cells accumulate over years: chronic lymphocytic leukaemia, the commonest leukaemia of Western adults, often idles and many never need treatment; chronic myeloid leukaemia, driven by the BCR-ABL fusion, went from fatal to near-normal life expectancy with imatinib.

Symptoms & signs

  • Often none — found on a routine blood count
  • swollen nodes (CLL)
  • enlarged spleen, early fullness
  • fatigue, night sweats, weight loss
  • repeated infections (CLL)

🚩 Get help if…

  • call 112 / 911 now Fever over 38 °C with shivers
  • see a doctor soon Drenching night sweats, fever or weight loss
  • see a doctor soon Lymph nodes or belly swelling fast
  • see a doctor soon Bruising, bleeding or infections that keep coming back

Where it strikes

Medical treatment

  • Blood count, flow cytometry, BCR-ABL test
  • Watch and wait for early, symptom-free CLL — early chemotherapy did not prolong life trials support
  • Imatinib and later tyrosine kinase inhibitors for CML — life expectancy near normal trials support
  • stopping the drug in deep, lasting remission — about half stay in remission
  • BTK inhibitors (ibrutinib, acalabrutinib, zanubrutinib) or venetoclax with obinutuzumab for CLL — ibrutinib raises atrial fibrillation and bleeding trials support
  • vaccinations and immunoglobulin for recurrent infections
  • stem-cell transplant for resistant disease

Natural & lifestyle

  • Vaccinations (no live vaccines in CLL)
  • infection precautions
  • exercise
  • avoid grapefruit and St John's wort with kinase inhibitors — they change drug levels

Emerging & experimental

  • Fixed-duration venetoclax + ibrutinib
  • asciminib first-line in CML
  • CAR-T and bispecific antibodies for Richter transformation

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Curcumin in chronic lymphocytic leukaemia — small studies early / small studies
  • Green tea extract (EGCG) in early CLL — a phase 2 trial lowered lymphocyte counts in some; liver toxicity possible early / small studies
  • Fenbendazole — anecdotal; no human trials anecdotal / traditional

ICD codes