Symptoms of chronic lymphocytic leukaemia (CLL)

Many people with chronic lymphocytic leukaemia (CLL) won't have any symptoms at all. They are diagnosed because they have 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.

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. 

Symptoms of CLL include:

  • swollen lymph glands Open a glossary item or tummy (abdominal) discomfort from an enlarged spleen
  • weight loss
  • infections that will not get better
  • feeling tired
  • anaemia Open a glossary item
  • bleeding or bruising
  • bone pain or night sweats

Swollen lymph glands or tummy (abdominal) discomfort from an enlarged spleen

In CLL, you can have swollen glands (lymph nodes Open a glossary item). The swollen glands are most often in your neck or under your arms. You may also get an enlarged spleen Open a glossary item. 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.

Diagram showing the position of the spleen

Weight loss

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.

Infections that will not get better

As the number of abnormal white blood cells Open a glossary item rise, you may pick up infections more easily. This is because the abnormal white blood cells cannot fight off infection as well as healthy ones.

Bleeding or bruising

The extra white blood cells take up more space in the bone marrow Open a glossary item 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.

Feeling tired

You might feel more tired than normal, even if you're getting a good night's sleep. This could be because you do not have enough red blood cells (anaemia).

Anaemia

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.

Bone pain and night sweats

Some people whose CLL has changed (transformed) into a high grade Open a glossary item 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.

  • Chronic lymphocytic leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up
    B Eichorst and others.
    Annals of Oncology, 2021. Volume 32, Issue 1, pages 22-33

  • Hoffbrand’s Essential Haematology (8th Edition)

    AV Hoffbrand and D A Steensma

    Wiley Blackwell, 2020

  • Chronic lymphocytic leukaemia

    N Jain and others

    The Lancet, 2024

    Published online, accessed August 2024

  • Diagnosis and Treatment of Chronic Lymphocytic Leukemia – A Review

    M Shadman

    The Journal of the American Medical Association, 2023

    Volume 329, Issue 11

Last reviewed: 
15 Aug 2024
Next review due: 
15 Aug 2027

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