While prognosis is highly variable and dependent on various factors including these mutations, the average 5-year relative survival is 86.1%. Telomere length has been suggested to be a valuable prognostic indicator of survival. In addition, a persons sex has been found to have an impact on CLL prognosis and treatment efficacy. More specifically, females have been found to survive longer (without disease progression) than males, when treated with certain medications. Epidemiology
CLL is the most common type of leukaemia in the Western world compared to non-Western regions such as Asia, Latin America, and Africa. It is observed globally males are twice as likely than females to acquire CLL. CLL is primarily a disease of older adults, with 9 out of 10 cases occurring after the age of 50 years. The median age of diagnosis is 70 years. In young people, new cases of CLL are twice as likely to be diagnosed in men than in women. In older people, however, this difference becomes less pronounced: after the age of 80 years, new cases of CLL are diagnosed equally between men and women.According to the American Cancer Society, in the United States, 13,040 males and 8,210 females (total of 21,250 people) are expected to be newly diagnosed with CLL in 2021. In that same year, 2,620 males and 1,700 females (total of 4,320 people) are expected to die from CLL.
In those without or only minimal symptoms watchful waiting is generally appropriate.CLL is treated by chemotherapy, radiation therapy, biological therapy, or bone marrow transplantation. Symptoms are sometimes treated surgically (splenectomy – removal of enlarged spleen) or by radiation therapy ("de-bulking" swollen lymph nodes).Initial CLL treatments vary depending on the exact diagnosis and the progression of the disease, and even with the preference and experience of the health care practitioner. Any of dozens of agents may be used for CLL therapy. Decision to treat
While it is generally considered incurable, CLL progresses slowly in most cases. Many people with CLL lead normal and active lives for many years—in some cases for decades. Because of its slow onset, asymptomatic early-stage CLL (Rai 0, Binet A) is, in general, not treated since it is believed that early-stage CLL intervention does not improve survival time or quality of life. Instead, the condition is monitored over time to detect any change in the disease pattern.The decision to start CLL treatment is taken when there is evidence for progressive symptomatic disease (summarized as "active disease").Clinical "staging systems" such as the Rai four-stage system and the Binet classification can help to determine when and how to treat the patient.Determining when to start treatment and by what means is often difficult; no survival advantage is seen in treating people with asymptomatic early-stage CLL. The International Workshop on CLL (iwCLL) has issued guidelines with specific markers that should be met to initiate treatment. Chemotherapy
Combination chemotherapy regimens are effective in both newly diagnosed and relapsed CLL.