Chronic Lymphoproliferative DIsorders

Question 1

What is the most important chronic lymphoproliferative disorder?

Answer 1

chronic lymphocytic leukemia

Question 2

Does chronic lymphoproliferative disorder have a long or short course

Answer 2

long - and indolent, but incurable, which is odd to say

Question 3

WHat cells are high in CLL?

Answer 3

small, MATURE lymphocytes (they don’t even look neoplastic)

Question 4

Are the lymphocytes in CLL B or T cells?

Answer 4

B cels

Question 5

What marker do the B cells have in CLL and why is this weird?

Answer 5

CD5 - weird because that’s usually a T cell marker and is only present on B cells at a certain stage of devlopment

Question 6

Why is infection common in CLL?

Answer 6

Because CLL is associated with hypogammaglobulinemia (we don’t know why)

Question 7

So in terms of immunophenotypeing for CLL, cells will be positive for what markers and negative for what marker?

Answer 7

positive for CD20 (B cell) and that CD5 mentioned earlier

negative for TdT (not blasts)

Question 8

In general, is treatment for CLL liberal or conservative?

Answer 8

conservative - often treatment is more difficult on the body than the leukemia is, so only treat if symptoms present

Question 9

What are some of the factors that affect prognosis in CLL?

Answer 9

WBC (lower is better)
adenopathy (less is better)
Bone marrow involvement (less is better)

Question 10

WHat’s the mean survival of CLL and what’s the usual cause of death?

Answer 10

9 years - infection

Question 11

For hairy cell leukemia, do you get splenomegaly or lymphadenopathy?

Answer 11

just splenomegaly (which is somewhat unusual)

Question 12

What sort of anemia do you get with hairy cell leukemia?

Answer 12

pancytopenia

Question 13

What stain can you use to look at hairy cells?

Answer 13

TRAP

Question 14

Hairy cell leukemia is most common in what group of people?

Answer 14

men (5:1) over 40 yrs old

Question 15

For hairy cell leukemia, if you don’t have pancytopenia, you will generally always have what?

Answer 15

monocytopenia (not sure why)

Question 16

What does immunophenotyping show in hairy cell leukemia?

Answer 16

B cell markers (CD20 and CD19), but no CD5 - that was CLL

Question 17

WHat’s the treatment and prognosis for hairy cell eukemia?

Answer 17

chemotherapy - really good (usually over 10 years)

Question 18

What’s the appearance of bone marrow in hairy cell leukemia?

Answer 18

chicken wire - because the cells look so far apart due to the excess cytoplasm

Question 19

What cells are high in prolymphocytic leukemia?

Answer 19

prolymphocytes (duh) - youll be able to pick them out because they have dense chromatin and nucleoli

Question 20

Is prolymphocytic leukemia more or less aggressive than CLL?

Answer 20

more aggressive

Question 21

What cells are high in large granulated lymphocyte leukemias?

Answer 21

large granulated T lymphocytes - they look really weird

Question 22

Why are infections so common in large granulated lymphocyte leukemia?

Answer 22

because you get neutropenia for some reason

Question 23

Is granulated lymphocyte leukemia a long or short course?

Answer 23

long - basically just considered a chronic disease