ERIC 2024 | The clinical manifestations of CLL: classical and constitutional symptoms

CLL is a very heterogeneous disease. So several patients, they don’t feel anything, so they just have their blood test done and somehow lymphocytes are increased. They are sent to a hematologist. Many of these patients have no symptoms for several years until they might become symptomatic. In general, there are very classic symptoms of CLL, such as lymphadenopathies, and also anemia or thrombocytopenia and patients might have symptoms related to anemia especially. It’s not very common to have symptoms related to thrombocytopenia because we usually treat the patients before they get to thrombocytopenia, except for those who present autoimmune complications such as autoimmune hemolytic anemia or thrombocytopenia or immune thrombocytopenia, in that case they might be symptomatic. And some patients also have symptoms related to splenomegaly, so sometimes they do have symptoms related to a very large spleen. And other patients, which in my opinion is the most subjective of all symptoms, are the constitutional symptoms because sometimes physicians must be aware that they might even interfere with the patient’s symptoms. The patients might become symptomatic because the physician tells them what they might feel. But it’s basically fever, weight loss and night sweats, which is somehow subjective, especially in very hot countries such as Brazil. Patients usually, especially in the public settings, they might have symptoms that are not related to CLL and we have to worry if we are not somehow influencing patients to report those symptoms.