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cancerologie# > 315 - Leucémie lymphoide chronique > Flashcards

315 - Leucémie lymphoide chronique Flashcards

1
Q

Mécanisme de la LLC

A

Prolifération lymphoide monoclonale B

MO, sang, gg

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2
Q

Fréquence LLC

Age d’apparition

A

Leucémie la plus fréq chez l adulte

Age médian 72A

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3
Q

Critères diagnostic de LLC

A

Lymphocytose >5.10^9 > 3M
Marqueur CD5 / CD23
Sd tumoral

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4
Q

Traitement de la LLC

A

Incurable

Mais on peut ralentir

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5
Q

Evolution naturelle de la LLC

A

1/3 même espérance de vie

Evolution très lente

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6
Q

Paraclinique du LLC

A 
NFS
Immunophénotypage
Myelogramme
EPS
Coombs direct
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7
Q

NFS dans la LLC

A

Chromatine mure et dense
15% = thrombopénie
30% = anémie
Reticulocytes augmentés

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8
Q

Immunophénotypage de la LLC

A

CD19 / CD20

CD 5 / CD 23

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9
Q

Score de la LLC

A

RMH
De 0 à 5
4/5 = LLC

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10
Q

Sd tumoral dans la LLC

A

Polyadénopathie superficielle
symétrique, ferme, indolore
Hépatomégalie

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11
Q

EPS dans la LLC

A

Hypergamma à IgM

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12
Q

Coombs direct dans la LLC

A

Vérifie l’association à l hémolyse

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13
Q

Diagnostic différentiel de la LLC

A

Lymphoprolifératif
Lymphome non Hodgkinien
MBL

Matutes 0-1-2

  • > Zone du manteau CD23-
  • > Zone marginale
  • > Folliculaire
  • > Grand lymphocyte granuleux
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14
Q

Pronostic de la LLC

A

Classification de Binet A,B,C

Mauvais pronostic
X2 lympho en 1A
Del (17p13) et Del( 11q22)
Mutation TP53
ZAP70
CD38
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15
Q

Stade A de Binet
Définition
Fréquence
Evolution

A

Moins de 3 aires gg
frq : 70%
Evo : 50% en A
50% en B ou C

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16
Q

Stade B de Binet
Définition
Fréquence
Evolution

A

Plus de 3 aires gg
frq : 20%
Evo : DC en 10A

17
Q

Stade C de Binet
Définition
Fréquence
Evolution

A

Hb < 100
Plq < 100

frq : 10%
Evo : DC en 10A

18
Q

Complications des LLC

A 
Infection
Insuffisance médullaire
Lymphome de haut grade
Cancer secondaire
Anémie hémolytique
19
Q

Sd de Richter

A

Lymphome de haut grade
Début de LLC

Aug rapide du syndrome tumoral
Aggravation signes généraux
Aug LDH

20
Q

Bilan pré thérapeutique de la LLC

A 
Bilan rénal
Scanner
Coombs
Serologie VHB, VHC
Cytogénétique
21
Q

Traitement de première ligne de la LLC

A

Agents alkylants
Analogue purine
Ac monoclonaux

cancerologie# (32 decks)

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