CLL

Question 1

classic presentation of CLL

Answer 1

80% = aysymptomatic - diag on routine bloods
M>F, 73y, white

painless symetrical lymphadenopathy, BM failure, FLAWS

Question 2

what is a richter’s transformation

Answer 2

CLL that has progressed to form a lymphoma

Question 3

Investigative findings in CLL

Answer 3

raised WCC with lymphocytosis
smear cells on film

BM - abnormal, lymphocytic replacement

Question 4

how are CLLs staged

Answer 4

Binet staging
A - raised WCC, <3 enlarged lymph nodes, No tx req, (12y survuval)
B - > 3 groups enlarged lymph nodes (5y survival)
C - anaemia + thrombocytopenia (2y survival)

Question 5

what mutations affect prognosis in CLL

Answer 5

17p mut = bad

p53 mut = worst

Question 6

what is the treatment ladder for CLL

Answer 6

if asymptomatic or slowly progressing - watchful waiting
Supportive = transfusions + injection prophylaxis

if p53 mut - 1st line = alemtuzumab