Chronic lymphocytic (lymphatic) leukaemia is a very slowly progressive form of white blood cell cancer found almost exclusively in the elderly. Most patients have only vague symptoms of tiredness or enlarged lymph nodes. The liver and spleen may enlarge, and in severe cases bleeding from nose and gums and into the skin may occur. The diagnosis is frequently made after a routine blood test to check for other ailments.
Because of its slow progress many patients are given no treatment, but if it becomes more active, steroids, monoclonal antibodies (eg. rituximab) and cytotoxic drugs are given. Severe anaemia or excessive bleeding may require an operation to remove the spleen. The disease is slowly but relentlessly progressive, with an average survival time of eight years, but because the patients are elderly, they frequently succumb to other diseases before the leukaemia.
Richter syndrome is an uncommon complication in which these patients suddenly deteriorate with the development of a lymphoma.