History and exam

Key diagnostic factors

common

Due to anaemia caused by CLL, or due to autoimmune haemolytic anaemia (a complication of CLL occurring in 5% to 10% of patients).[34][35]

Shortness of breath may be present in patients with advanced disease.

Painless lymphadenopathy is common.[3]

Presence of lymphadenopathy can guide staging and treatment. See Diagnostic criteria and Management sections.

Present in approximately 50% of cases.[4]

Presence of splenomegaly can guide staging and treatment. See Diagnostic criteria and Management sections.

uncommon

Present in approximately 14% of cases.[4]

Presence of hepatomegaly can guide staging and treatment. See Diagnostic criteria and Management sections.

Other diagnostic factors

common

Risk factors include age over 60 years, male sex, white ethnicity, and positive family history.

uncommon

A minority of patients (approximately 10%) present with B symptoms (fever, drenching night sweats, unintentional weight loss) or other symptoms (e.g., chills, fatigue).[4]​

Presence of B symptoms can guide treatment. See Management section.

Due to dysfunctional lymphocytes and subsequent hypogammaglobulinaemia.

May be present in patients with advanced disease.

Sign of thrombocytopenia.

May be present in patients with advanced disease.

Sign of anaemia.

Sign of thrombocytopenia.

Risk factors

strong

Median age at diagnosis in the US is 70 years; approximately 69% of diagnoses occur in people aged ≥65 years.[7]

Approximately 5% to 10% of cases are familial.[15][16]

One Swedish registry study reported a 7.5-fold increased risk for CLL in first-degree relatives of those with CLL.[31]

weak

CLL is more common in men than in women (6.3 vs. 3.3 new cases per 100,000, respectively; 2017-2021 age-adjusted US data).[7]

CLL is more common in white people than people of other races/ethnicities.[7]

In the US, incidence in non-Hispanic white people is 7.8 per 100,000 males and 4.1 per 100,000 females, respectively (2017-2021, age-adjusted US data).[7]

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