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In the early stages of the disease, clinical symptoms of chronic lymphocytic leukemia (CLL) may not be obvious or may be overlooked by the patient. As the disease progresses, however, signs and symptoms become more evident. Patients may complain of generalized weakness or fatigue, may notice swollen lymph nodes, or develop recurring infections.

To diagnose chronic lymphocytic leukemia, the health care provider will obtain the patient's past medical history, perform a physical examination, and draw blood for a complete blood count (CBC). During the physical examination, the doctor will check for the presence of CLL symptoms including swollen lymph nodes and enlargement of the spleen or liver.

It is important to note, however, that approximately 50% of patients with CLL have no clinical symptoms of the disease at the time of presentation and that many cases of CLL are detected by a routine blood test in persons with no clinical symptoms. The major blood abnormality in people with CLL is an abnormal increase in the number of lymphocytes in the bloodstream, a condition known as lymphocytosis.