There are several forms of leukemia, some of which are more common than others. more common in adults than in children. If overall it is rather rare, but chronic lymphatic leukemia is nevertheless more often found in senior citizens. It is important to know thinking about it, in the face of signs that most of the time are very banal at first. Dr. Claude Leroy
Chronic lymphocytic leukemia (CLL) is actually a proliferation of lymphocytes (most often type B), which are among the main defence cells.
of the organism. This leukaemia affects men twice as much as women and
rather those who have passed the age of 50, with a maximum frequency around Sixty-five years old. Its exact causes remain poorly known – except for a predisposition genetic in a few minority cases. It is currently not curable, but fortunately, it’s evolving slowly. However, it does not prevent it from aggravating the fragility induced by senescence in general. More than 1,300 new cases occur every year in Belgium, according to the Cancer Foundation.
Invasion or even partial self-destruction
Simply put, some B-cell populations do not don’t die like they should after a while. From then on, their The number increases until it invades the blood and bone marrow.
Since the type of lymphocyte involved is involved in the recognition of the
normal cells in the body and that there is a malfunction in that mechanism,
Chronic lymphocytic leukemia is frequently complicated by autoimmune diseases. These are conditions in which, in a way, the body has a tendency to self-destruct through the fault of its own defense cells – which are supposed to go after abnormal cells, bacteria, etc. instead.
No signs in about 1/3 of cases
In general, chronic lymphocytic leukemia is discovered somewhat by chance when a blood test shows a clear lymphocytosis.
(an increase in the number of lymphocytes). It is confirmed by of blood, usually more extensive (B-cell testing). monoclonal, type CD5+, CD19+ and CD20+).
Signs are present in only about 2/3 of the cases. These are often adenopathies (“swollen lymph nodes”) or splenomegaly (an enlargement of the spleen, which can be seen on examination of the abdomen by the doctor). An alteration of the general state can be observed, with anaemia. The problem is that anemia is in any case common in the elderly person. His presence is therefore not such as to arouse suspicion.
The karyotype (study of chromosomes) of abnormal B lymphocytes can give indications on the prognosis (stages A, B or C), on the slow evolution or
that the disease is likely to follow in a given person. Finally,
Immunophenotyping can also tell if it is chronic lymphocytic leukemia or another related disease.
What is particularly important to remember in presence of chronic lymphocytic leukemia is the aforementioned tendency to anemia, but also to thrombocytopenia (lack of platelets) increasing the risk hemorrhages, and neutropenia (lack of neutrophil white blood cells), which makes the bed bacterial infections.
Postpone the deadline with a
good specialized follow-up
In general, it is useless to treat leukemia… stage A chronic lymphocytic which remains stable. As for the other two stages, they are
usually treated with chemotherapy, and sometimes with a bone marrow transplant.
In recent years, newer drugs such as monoclonal antibodies have made it possible for a more targeted treatment in some cases. Corticosteroids help limit the impact of the associated autoimmune diseases, and immunoglobulins may also be administered (by IV injection) to increase at least the body’s defenses against the effects of the to germs.
Follow-up by a hematologist and an oncogeriatrist is obviously indicated. On the one hand, because the individual treatment can obviously be more
the complex that the few general elements repeated in the preceding lines, and on the other, because new treatments are appearing on a relatively regular basis.
What to spot, seek and do?
- Are we seeing more and more chronic lymphatic leukaemias in a nursing home?
Yes, and the reason seems to lie in increased life expectancy.
- What are the possible warning signs to which personnel and doctor have to stay alert?
In addition to fatigue, which is a very common sign of illness in
we often see weight loss through a decrease in weight.
appetite, and night sweats. Nothing specific, then, but
this must lead to the search, during the clinical examination, for
enlarged lymph nodes and/or splenomegaly, as well as to a catch.
of blood.
- What to do if a senior citizen has a bacterial infection suffering from chronic lymphocytic leukemia?
Prescribe antibiotics immediately.
- Should anemia be treated, or not necessarily?
Yes, it does. And the same goes for thrombocytopenia.
- Any other possible signs?
Rapid shortness of breath and tachycardia on exertion can be
due to anemia. Sometimes a fever with no obvious infection,
or a vague sense of abdominal discomfort. Sometimes
also, bruises for no clear reason, a phenomenon which is not
is consistent with a lack of platelets.