CLL is a chronic disease, meaning that it slowly accumulates over time. Because of this, CLL is most common among the elderly. The average age of patients with CLL is 75, and more than half of patients are 70 years or older at the time of their diagnosis. A CLL diagnosis is unusual in individuals younger than fifty years old. Those 70 and older are more likely to have a lower tolerance for therapies and are more prone to complications throughout the course of their disease. This issue is being addressed by the development of more targeted, less harsh treatments.
CLL patients experience nonspecific or no symptoms, making diagnosis impossible based on symptoms alone. One of the more common complaints of CLL patients is the presence of fatigue; patients describe themselves as drained of energy. They require multiple rest periods during the day to perform their normal activities. This reduced energy does not appear to be necessarily related to the stage of the disease, as it is not uncommon to be found in early CLL. Fatigue appears to be more noticeable in women. Patients with CLL also complain about difficulties in concentration and in performing complex tasks. While the exact cause of these symptoms is unknown, this is an area of active study. The symptoms may result from an immune reaction by normal lymphocytes to the persistence of the CLL cells.
Additional symptoms related to CLL include enlarged lymph nodes, fever, night sweats and weight loss. Frequent infections can occur due to the compromised immunity of patients. Shortness of breath is also common and can be related to a lack of healthy red blood cells. Easy bruising is often reported and is related to a lack of platelets. These symptoms can interfere with a patient’s performance, ability to work and daily responsibilities and activities. Patients with CLL can live for many years and need specific recognition and intervention programs to reduce the burden of leukemia on their quality of life.