CLL Prognosis

Last Modified: January 8, 2006

Dear OncoLink "Ask The Experts,"

I am a 48-year-old male recently diagnosed with CLL ( chronic lymphocytic leukemia ). My white blood cell count is 14.05, my red count is 4.59, and my hemoglobin count is 14.1. I just had a bone marrow biopsy, but have not received the results yet. I am also scheduled for a CT scan.

I am fairly active, I run 3 miles 3 times a week and do resistance training 3-4 times a week. Should I stop exercising and conserve my energy? I am concerned about becoming anemic. What is the general prognosis for CLL patients these days?

Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:

I don't think you should stop exercising unless you feel tired. In general, studies show that even people with anemia have more energy if they do exercise (now, most of the studies were talking about a walk around the block, not your extent of exercise), but as long as you feel well, I see no reason not to stay active.

As far as prognosis, th is varies based on a staging system called the " Rai system for CLL" - it is dependent on any swelling of lymph nodes, splee n, or liver and the presence of anemia and/or low platelet count and high white cell count. The stages range from 0 to I V, but have been simplified to low, intermediate, and high risk.

Rai System for CLL

Simplified Stage	Clinical Features	Median Survival
Low risk	Lymphocytosis (elevated WBC) in blood & bone marrow only	> 12.5 years
Intermediate Risk	Lymphocytosis + lymphadenopathys (enlarged lymph nodes)	8.5 years
	Splenomegaly or hepatomegaly (enlarged spleen or liver)	6 years
High risk	Lymphocytosis, anemia & thrombocytopenia (low platelet count)	1.5-4 years

Many patients with CLL can go on for years without treatment, and be managed with just regular monitoring of blood counts. It all depends on the aggressiveness of that person's disease.