CLL can have no symptoms for years. When there are symptoms, it means the disease has become more active. That’s when oncologists give chemotherapy drugs like Ibrutanib. It is also considered a sign of active disease when WBC counts start to double every six months. Symptoms can include increased infections, a swollen liver or spleen, or night sweats. In the meantime, it is one of the few cancers where we can legally do primary care, since there is no treatment until the disease progresses.