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Symptoms

Read about possible symptoms of chronic lymphocytic leukaemia (CLL) and when to see your doctor.

Many people with chronic leukaemia won't have any symptoms at all. About 50 out of every 100 cases of CLL (50%) are diagnosed because a person has a routine blood test for something else.

In CLL symptoms tend to be mild at first and get worse slowly. Many symptoms are vague. You may feel as if you had the flu.

Common symptoms

Remember, many people with CLL have no symptoms at first. Many of the symptoms listed below occur in CLL but are more likely to be caused by other illnesses. 

CLL may cause:

In CLL, you can have swollen glands (lymph nodes). The swollen glands are most often in your neck or under your arms. You may also get an enlarged spleen. The spleen is an organ on the left of your body, just under your ribs. If your spleen becomes much bigger than normal, it can be uncomfortable or painful. Your doctor may be able to feel that the spleen is enlarged.

Swollen lymph glands or abdominal discomfort from an enlarged spleen.jpg

CLL itself uses up energy that your body would otherwise use or store. So you may lose weight, even if you eat normally. Rarely, an enlarged spleen may also increase the weight loss by squashing your stomach and making you feel full more quickly than usual. You may then eat less than normal.

As the numbers of abnormal white blood cells rises, you may pick up infections more easily. This is because the abnormal white blood cells cannot fight off infection as well as healthy ones.

The lack of space in the bone marrow also interferes with the production of red blood cells. These normally help to carry oxygen around the body. If you do not have enough red blood cells, this is known as anaemia. You may feel breathless and tired. Anaemia is generally a later symptom of CLL.

Other symptoms

The extra white blood cells take up more space in the bone marrow as their numbers grow. So there is not enough room for platelets to be made. Platelets help to clot the blood, so you may have nosebleeds, unexplained bruising or unusually heavy periods. This is generally a later symptom of CLL, rather than an earlier one. Often bleeding and bruising happens in people who have a bleeding condition as well as CLL.

Some people whose CLL has changed (transformed) into a high grade disease have bone pain and night sweats. Bone pain happens because there are too many leukaemia cells in the bone marrow, causing pressure on nerves and causing pain. The exact cause of the night sweats is unknown.

What to do if you have these symptoms

If you have any of these symptoms you must have them checked by your GP. But remember, they can all be caused by other conditions. Everyone's lymph glands swell up when they have a throat infection for example. Most people with these symptoms will not have chronic leukaemia.

Last reviewed: 
15 Apr 2015
  • Chronic lymphocytic leukemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up
    B Eichorst and others. Annals of Oncology, 2011, Vol. 22 (Supplement 6): vi50-vi54

  • Principles and practice of oncology (10th edition)
    VT  De Vita, S Hellman and SA Rosenberg
    Lippincott, Williams and Wilkins, 2015

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