Chronic Lymphoid Leukaemia

Question 1

Chronic Lymphocytic Leukaemia;

The ? common leukaemia.
Twice as common in ?.
Median age of presentation ? years.

Answer 1

most
males
70

Question 2

Pathophysiology;

Accumulation of ? B-cells that have escaped ?, and this increasing mass of immune-? cells leads to bone marrow ?.

Answer 2

mature
apoptosis
incompetent
failure

Question 3

Symptoms;
- often ?, surprise finding on a routine FBC.
The patient may be ? or ? prone, or if severe there can be ? symptoms.
On examination there are ? ? lymph nodes, and ?.

Answer 3

none
anaemic
infection
b
enlarged non-tender
hepatosplenomegaly

Question 4

Ix

FBC: markedly raised ?, may be signs of bone marrow failure.
? ? develops later.
Blood film : predominant ? cells (? mature lymphocytes).

Answer 4

lymphocytes
AI haemolysis
smudge
small

Question 5

Management;

• Without treatment, ? never progress, ? will eventually progress and ? will actively progress from diagnosis.
• Treatment is thus only indicated if ?, or there are ? markers of poor prognosis.
• Treatment can be with ? , or ? to relieve
  hepatosplenomegaly.

Answer 5

1/3
1/3
1/3
Sx
cytogenetic
CTx
RTx

Question 6

Prognosis;
Depends on ? stage;
o Stage 0: ? alone; >13 years mean survival.
o Stage 1: ? and ?, 8 years.
o Stage 2: lymphocytosis and ?, 5 years.

Answer 6

rai
lymphocytosis
lymphocytosis and Lymphadenopathy
hepatosplenomegaly

Question 7

o Stage 3: lymphocytosis and ?, 2 years.
o Stage 4: lymphocytosis and ?, 1 year.
Death is usually due to ?, or transformation to an aggressive
lymphoma (? syndrome).

Answer 7

anaemia
thrombocytopenia
infection
richter’s