Chronic Lymphocytic Leukaemia (CLL)

Question 1

What cells proliferate?

Answer 1

Mature B cells

Question 2

Why does it differ from lymphoma?

Answer 2

Accumulation is in the blood and bone marrow

Question 3

S+S:

Most are asymptomatic and detected incidentally!

What 3 signs of abdo exam may indicate otherwise?

They get cytopenia from bone marrow infiltration or autoimmunity. What S+S would you see?

Systemic symptoms - 3

Answer 3

Lymphadenopathy
Splenomegaly
Hepatomegaly

Anaemia - SOB and fatigue
Thrombocytopaenia - petechiae

Weight loss
Sweats
Anorexia

Question 4

Investigations:

FBC:

• WBC with lymphocytes are raised. How long do they have to be raised to make a diagnosis?
• What are some sign of marrow infiltration?

Other bloods:
- What is found on blood film?

A biopsy is used for main diagnosis. What else can be biopsied?

Answer 4

3 months

Low platelets
Low Hb
Low neutrophils

Lymphocytosis and smudge cells (lymphocytes damaged in slide prep) *****

Lymph nodes

Question 5

Management:

Same as always!

What type of haemolytic anaemia is CLL associated with?

Answer 5

Same as always!

Warm autoimmune intravascular haemolysis

Question 6

What type of lymphoma can it transform into?

What is the main complication?

Answer 6

High-grade non-Hodgkins lymphoma

Recurrent infection from Rx or disease