Leukemia is the term for cancer that starts in white blood cells. Coughing is a symptom of some types of leukemias, including chronic lymphocytic leukemia (CLL).

CLL can lead to a dry cough if the condition grows and enters the lungs. However, this rarely happens.

A cough may also occur as a side effect of chemotherapy, or it might indicate the development of a secondary cancer in the lungs.

CLL is one of the most common types of leukemia in adults, with an estimated 21,250 new cases occurring in the United States in 2021.

This article discusses coughing as a symptom of leukemia. It also looks at the other possible causes of coughing and some of the treatment options.

A person coughing who may have CLL.Share on Pinterest
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Coughing can be a symptom of other types of leukemia, as well as CLL. These include:

Juvenile myelomonocytic leukemia

Juvenile myelomonocytic leukemia is a rare blood cancer that mostly affects young children. It involves the uncontrolled growth of monocytes, which are immature white blood cells. A dry cough is a possible symptom of juvenile myelomonocytic leukemia.

Acute lymphoblastic leukemia

Acute lymphoblastic leukemia (ALL) is a rapidly growing cancer that affects immature lymphocytes, which are white blood cells that play a role in the immune system.

ALL has several subtypes, including T-cell ALL. T-cell ALL enlarges the thymus gland, a small organ in the middle of the chest. An enlarged thymus puts pressure on the windpipe and can cause coughing as a symptom.

Acute myeloid leukemia

Acute myeloid leukemia starts in the bone marrow but typically moves into the blood. It may spread to other organs, such as lymph nodes and the liver. It can increase a person’s vulnerability to coughs and colds, which may last longer than usual.

CLL typically causes coughing due to:

Lung involvement

CLL is a cancerous blood condition that increases the number of B lymphocytes, a type of white blood cell that makes antibodies to fight infections. However, CLL causes the production of abnormal B lymphocytes, which doctors refer to as leukemia cells.

Leukemia cells are ineffective in fighting infections compared with healthy B lymphocytes. Their growth also leaves less room for healthy lymphocytes, which increases the person’s vulnerability to infections.

CLL advances slowly, and the leukemia cells can spread to various body parts, including the spleen, lymph nodes, and lungs. According to an older study from 2009, in rare cases, CLL can enter the lungs to cause a dry cough and progressive breathing problems.

A secondary cancer

Although treatment rarely cures CLL, it can control the disease for long periods. However, during these periods, people with CLL may develop a secondary cancer, which can occur anywhere in the body, including the lungs. One of the symptoms of lung cancer is a chronic cough.


Some chemotherapy drugs for treating CLL may cause lung toxicity, according to research from 2011. These medications suppress the immune system, which increases the risk of coughs as the body is unable to fight off respiratory infections properly.

A person should speak with a doctor if they experience:

  • shortness of breath or difficulty breathing
  • a persistent cough that lasts for weeks
  • wheezing
  • fever

The treatment options for CLL will depend on the severity of the disease, as well as the person’s overall health.

Asymptomatic CLL

Asymptomatic CLL causes no symptoms. Rather than treating the disease, doctors may advise watchful waiting while they monitor how it progresses.

Symptomatic CLL

The treatment for people with symptoms from CLL could include:

  • More watchful waiting: Doctors may continue monitoring the condition if the symptoms are mild and the disease is progressing slowly.
  • Targeted therapy: This involves medications that target specific cancerous cells, such as ibrutinib (Imbruvica).
  • Immunotherapy: These medications support the immune system to fight leukemia. One example is lenalidomide (Revlimid), which people may sometimes receive in combination with rituximab (Rituxan).
  • Bone marrow transplant: Doctors may suggest a bone marrow transplant to replace damaged cells with healthy blood-forming stem cells.

Recurrent CLL

Doctors may use a combination of treatments to treat persistent cases of CLL. These treatments may include targeted therapy, immunotherapy, and bone marrow transplants. A doctor might also suggest radiation therapy.

Another option is CAR T-cell therapy, which involves adding chimeric antigen receptors (CARs) to T cells in a person’s body, helping the immune system recognize and attack cancerous cells.

Most individuals with CLL live many years following a diagnosis. They will typically require treatment to fight the condition, which doctors may administer on and off for years. The 5-year relative survival rate for people with CLL is 87%. This statistic shows the percentage of people likely to survive 5 years from diagnosis compared with those living without the disease.

Many of the possible causes of a chronic cough are more common than cancer. Research from 2015 reports that various conditions may cause a chronic, dry cough, including:

  • Viral infections of the upper respiratory tract: The common cold may cause a dry cough that lingers after other symptoms disappear.
  • Gastroesophageal reflux disease (GERD): This condition typically causes heartburn and regurgitation. GERD can also cause a chronic cough.
  • Upper airway cough syndrome: This can occur from postnasal drip or irritation of the upper airway structures that stimulate the cough reflex.
  • Cough variant asthma: Inflammation in this condition causes an ongoing cough that usually occurs at night.
  • Lung diseases: A chronic cough is a symptom of several lung conditions, including emphysema, chronic bronchitis, and pulmonary fibrosis.
  • Side effects from angiotensin converting enzyme (ACE) inhibitors: ACE inhibitors relax the blood vessels to lower blood pressure.
  • Sleep apnea: This condition involves episodes in which breathing stops during sleep.
  • Psychogenic or unexplained: These are coughs that occur despite there being no evidence of physical disease.

A chronic, dry cough is not necessarily due to CLL or any other type of leukemia. It may stem from a range of other causes, such as emphysema or a cold.

People with CLL may experience a cough from chemotherapy treatment, leukemia cells spreading to the lungs, or a secondary form of cancer. The treatment of CLL may include targeted therapy, immunotherapy, or a bone marrow transplant.