CHRONIC LYMPHOPROLIFERATIVE LEUKEMIC DISORDERS (CLL)

Question 1

CLL

Answer 1

Chronic lymphocytic leukemia (CLL)
Prolymphocytic leukemia (PLL)
Hairy cell leukemia (HCL)

Question 2

Reduced rate of cell death > Increased rate of cell production

Answer 2

Reduced rate of cell death > Increased rate of cell production

Question 3

Most common type of leukemia in the Western hemisphere

Answer 3

CHRONIC LYMPHOCYTIC LEUKEMIA

Question 4

Is not related to exposure to ionizing radiation

Answer 4

CHRONIC LYMPHOCYTIC LEUKEMIA

Question 5

Factors:

Answer 5

Age
Gender – male
Inherited or acquired immunologic defects
Virus – Human T-lymphotrophic virus (HTLV)
Genetic factors

Question 6

Is less likely to undergo acute exacerbation than the other leukemias

Answer 6

CHRONIC LYMPHOCYTIC LEUKEMIA

Question 7

CHRONIC LYMPHOCYTIC LEUKEMIA

CLINICAL PRESENTATION

Disease of the elderly

survive without treatment

Median survival =

Answer 7

(90% >50 years;
65% >65%)

Male 2x than females

Benign to severe

10-15%

3-4 years

Question 8

CHRONIC LYMPHOCYTIC LEUKEMIA

LABORATORY FINDINGS

Persistent lymphocytosis

Answer 8

(abs count = 10-150 to 1000 X 109/L)

Lymphocytes appear normal or slightly larger than normal with clumped or condensed chromatin

Cleft nuclei – follicular origin

(+) smudge cells
Neutropenia

Question 9

CHRONIC LYMPHOCYTIC LEUKEMIA

stain intensely with PAS

Answer 9

Increased glycogen content in lymphocytes

Question 10

CHRONIC LYMPHOCYTIC LEUKEMIA

LABORATORY FINDINGS

Plasma immunoglobulins –

BM aspirates –

Marrow lymphocytes =

Marrow erythroid cells are

Answer 10

Plasma immunoglobulins – reduced

BM aspirates – not necessary EXCEPT for those “aleukemic” and “subleukemic” stages

> 30%
Marrow lymphocytosis + peripheral blood lymphocytosis = CLL

megaloblastic

Increased mast cells