1: CLL Flashcards
what is chronic lymphoid leukaemia
mutation in mature lymphocytes
what are 99% of CLL cases
B-lymphocyte
what is the commonest leukaemia
CLL
what age does CLL affect
Peak: 70-72 year-olds
what is problem with identifying CLL
50% are asymptomatic and therefore not detected until late stages
what are symptoms of CLL
- Painless lymphadenopathy
- Hepatosplenomegaly
- Recurrent Infections
- Anaemia symptoms
- Constitutional
how will FBC present in CLL
Lymphocytosis
what is seen on peripheral blood smear in CLL
Smudge cells
what are smudge cells
rupture lymphocytes - as they rupture easily
what is the problem with smudge cells alone
NOT diagnostic for CLL
what is diagnostic for CLL
bone-marrow biopsy
what will be seen on bone marrow aspiration
> 20% lymphocytes
what are two staging systems used for CLL
Rai and Binet
what staging system is used for CLL in the UK
Binet
what is binet stage A
Less than 3-groups lymph nodes
what is binet stage B
More than 3-groups lymph nodes
what is binet stage C
Spleen involvement
Low RBC, Low platelets
what is given if symptomatic in CLL
Chemotherapy
what is given to treat lymphadenopathy or splenomegaly in CLL
Radiotherapy
what is used for recurrent infections in CLL
IVIg
explain rule of thirds in CLL
- One third never progress
- One third progress slowly
- One third progress rapidly
what condition is associated with 10-15% CLL
Warm autoimmune haemolytic anaemia
what complicates 5% of CLL
Richter’s transformation
what is richter’s transformation
CLL transforms to aggressive form lymphoma
how can richter’s transformation be identified
- new-onset B-Symptoms
- rapidly progressive lymphadenopathy
