Chronic Lymphocytic Leukaemia Flashcards

1
Q

Define Chronic Lymphocytic Leukaemia (CLL)?

A

Characterised by progressive accumulation of functionally incompetent lymphocytes, which are monoclonal in origin. There is an overlap between CLL and non-Hodgkin’s
lymphoma

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2
Q

What is the aetiology of CLL?

A

Malignant cells may accumulate as a result of their inability to undergo apoptosis

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3
Q

What are the most common chromosomal changes in CLL?

A

Trisomy 12

11q and 13q deletions

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4
Q

What is the epidemiology of CLL?

A

90% are > 50 yrs
More common in males
Rare in Asians

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5
Q

What are the presenting symptoms of CLL?

A

Asymptomatic: 40-50% of cases are diagnosed following routine blood tests
Systemic Symptoms
Symptoms of Bone Marrow Failure

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6
Q

What are the systemic symptoms of CLL?

A

Lethargy
Malaise
Night sweats

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7
Q

What are the symptoms of Bone Marrow Failure in CLL?

A

Recurrent Infections
Herpes Zoster Infection
Easy Bruising or bleeding

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8
Q

What are the signs of CLL on physical examination?

A

Non-tender lymphadenopathy
Hepatomegaly
Splenomegaly
Late stage signs of bone marrow failure

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9
Q

What are some of the late stage signs of bone marrow failure in CLL?

A

Pallor
Cardiac Flow murmur
Purpura/ecchymosis

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10
Q

What can CLL be associated with?

A

Autoimmune phenomena such as haemolytic anaemia (warm agglutins) or thrombocytopaenia

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11
Q

What bloods would you do for CLL and what would you see?

A
FBC:
Lymphocytosis 
Low Hb
Low Platelets 
Low Serum Ig
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12
Q

What could the Low HB be due to in CLL?

A

Bone marrow infiltration
Hypersplenism
Autoimmune haemolysis

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13
Q

What would you see on a Blood film for CLL?

A

Small lymphocytes with thin rims of cytoplasm

Smudge Cells

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14
Q

What would you see on a Bone Marrow Aspirate or Biopsy for CLL?

A

Lymphocytic replacement of normal marrow

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15
Q

What other investigation might you want to do for CLL?

A

Cytogenetics

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