Symptoms:

Symptoms usually develop slowly over time. Many cases of CLL are detected by blood tests done in people for other reasons or who do not have any symptoms.

Symptoms that can occur include:

• Abnormal bruising (occurs late in the disease)
• Enlarged lymph nodes, liver, or spleen
• Excessive sweating, night sweats
• Fatigue
• Fever
• Infections that keep coming back (recur)
• Loss of appetite or becoming full too quickly (early satiety)
• Unintentional weight loss

Signs and tests:

Patients with CLL usually have a higher-than-normal white blood cell count.

Tests to diagnose and assess CLL include:

• Complete blood count (CBC) with white blood cell differential
• Bone marrow biopsy
• CT scan of the chest, abdomen, and pelvis
• Immunoglobulin testing
• Lactate dehydrogenase test

If your doctor discovers you have CLL, tests will be done to see how much the cancer has spread. This is called staging.

There are two systems used to stage CLL:

• The Rai system uses numbers 0 to IV to group CLL into low-, intermediate-, and high-risk categories. Generally, the higher the stage number, the more advanced the cancer.
• The Binet system uses letters A-C to stage CLL according to how many lymph node groups are involved and whether you have a drop in the number of red blood cells or platelets.

Some newer tests look at the chromosomes inside the cancer cells. The results can help your doctor better determine your treatment.