Chronic lymphocytic leukemia (CLL) is the most common form of adult leukemia in the United States, and it is also one of the lymphoid cancers most consistently linked to glyphosate exposure in the epidemiologic literature. For the Roundup litigation, CLL is among the qualifying diagnoses our team evaluates routinely. This guide walks through what CLL is, how it is diagnosed, the science of the glyphosate-CLL association, the treatment landscape, and what CLL Roundup cases need.
What CLL Is
Chronic lymphocytic leukemia is a slow-growing cancer of B lymphocytes — a type of white blood cell that normally helps fight infection. In CLL, the affected B cells multiply uncontrollably and accumulate in the blood, bone marrow, lymph nodes, and spleen. The disease shares many biologic features with small lymphocytic lymphoma (SLL); in fact, CLL and SLL are considered the same disease with different presentations, and the literature often refers to them together as CLL/SLL.
CLL is classified as a non-Hodgkin lymphoma (NHL) under the World Health Organization classification system. That classification matters for the Roundup litigation because the qualifying diagnosis framework used by federal and state courts in NHL cases generally encompasses CLL/SLL.
How CLL Gets Diagnosed
CLL is often discovered incidentally. Many patients have no symptoms at the time of diagnosis. The trigger is usually an abnormal complete blood count (CBC) showing an elevated lymphocyte count — sometimes during a routine physical, sometimes during workup for another condition entirely.
Confirmation involves:
- Flow cytometry on peripheral blood, identifying the characteristic immunophenotype (CD5+, CD19+, CD23+, weak CD20, weak surface immunoglobulin).
- Sometimes a bone marrow biopsy, although this is no longer always required for diagnosis.
- FISH testing (fluorescence in situ hybridization) for prognostic chromosomal abnormalities — deletion 17p, deletion 11q, trisomy 12, deletion 13q.
- IGHV mutation status testing.
- CT imaging or sometimes PET imaging to assess lymph node and spleen involvement.
The Glyphosate-CLL Connection
The epidemiologic literature linking glyphosate exposure to CLL specifically is part of the broader NHL evidence base. Key elements:
- The 2015 IARC Monograph 112 classified glyphosate as "probably carcinogenic to humans" (Group 2A) based in part on human studies showing elevated NHL rates — which by classification includes CLL.
- The Zhang et al. 2019 meta-analysis in Mutation Research reported elevated relative risk for NHL associated with high glyphosate exposure, with subtype-specific analyses including CLL within the NHL pool.
- Multiple case-control studies from agricultural worker populations have found associations between pesticide exposure (including glyphosate) and CLL specifically.
- Mechanistic evidence — oxidative stress, DNA damage, immune system disruption — provides plausibility for the association.
The defense disputes the strength of the CLL-specific association in some cases by arguing that CLL has a less robust epidemiologic link than DLBCL or follicular lymphoma. The plaintiffs' response cites the inclusion of CLL within the NHL classification, the consistency across studies that did report subtype-specific findings, and the broad biological mechanism that applies across lymphoid malignancies.
Treatment Landscape
CLL treatment has evolved substantially. The historical chemoimmunotherapy regimens (FCR, BR) have been largely replaced by targeted therapies:
- BTK inhibitors (ibrutinib, acalabrutinib, zanubrutinib) — first-line for many patients.
- BCL-2 inhibitors (venetoclax) — often combined with rituximab or obinutuzumab.
- Anti-CD20 monoclonal antibodies (obinutuzumab, rituximab) — backbone of many combination regimens.
- CAR-T cell therapy — FDA-approved options for relapsed/refractory CLL after multiple prior lines.
- Allogeneic stem cell transplant — reserved for high-risk relapsed/refractory disease.
CLL is often a chronic, indolent disease — patients may live for many years with periodic treatment cycles. Some patients require no treatment for years after diagnosis (the "watch and wait" approach). Others require active therapy from the start. The disease course is highly variable.
What CLL Roundup Cases Need
- Pathology confirmation of CLL/SLL. Flow cytometry showing the characteristic immunophenotype, with or without bone marrow biopsy.
- Substantial Roundup or glyphosate exposure history. Occupational exposure (farmworker, landscaper, applicator) or sustained residential use over years.
- Exposure documentation. Employment records, product use records, witness statements.
- Risk-factor analysis. CLL has known genetic predisposition (family history of CLL or other lymphoid malignancies). The case can account for this and still proceed; the question is whether glyphosate exposure was a substantial contributing factor.
- Treatment history. What lines of therapy, what response, what current status.
The Damages Picture for CLL Cases
CLL is a chronic disease, which changes the damages calculation compared to aggressive lymphomas like DLBCL. CLL cases typically include:
- Past and ongoing treatment costs — targeted therapy is expensive and often long-term.
- Surveillance imaging and laboratory monitoring (often for years).
- Lost wages and reduced earning capacity during active treatment cycles.
- Long-term sequelae — immune compromise, infection risk, secondary cancers, treatment-related cardiovascular effects (some BTK inhibitors).
- Pain and suffering and loss of enjoyment of life over the chronic course of the disease.
- Wrongful death and survival action damages for fatal cases (CLL ultimately progresses for many patients).
If You or a Family Member Has CLL
Free, confidential case review. CLL cases with documented Roundup or glyphosate exposure history are among the diagnoses we evaluate most frequently.
- Read about who qualifies generally: Who Qualifies for a Roundup Lawsuit.
- Read about NHL subtypes: NHL Subtypes and Roundup.
- Read about DLBCL: DLBCL and Roundup.
- Read about the leukemia framework: Leukemia Lawsuit Overview.
Free case review. No fees unless we recover compensation for you.
Sources
- International Agency for Research on Cancer (IARC) — Monograph 112 on glyphosate. iarc.who.int
- National Cancer Institute — Chronic Lymphocytic Leukemia treatment and statistics. cancer.gov
- American Society of Hematology — CLL clinical guidelines and treatment landscape. hematology.org
- Leukemia & Lymphoma Society — CLL patient information and support resources. lls.org
- Zhang L et al. — "Exposure to glyphosate-based herbicides and risk for non-Hodgkin lymphoma: A meta-analysis and supporting evidence." Mutation Research, 2019. ncbi.nlm.nih.gov
- Agricultural Health Study — NIH cohort study of pesticide applicators. aghealth.nih.gov
- World Health Organization — Classification of Tumours of Haematopoietic and Lymphoid Tissues. who.int