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Haematology > CLL > Flashcards

CLL Flashcards

1
Q

What is chronic lymphoid leukemia

A

A neoplastic proliferation of mature looking lymphoid cells affecting blood, bone marrow and other organs

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2
Q

Disease of what age

A

over 40 years

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3
Q

Classification

A

B Lymphoid leukemias

T Lymphoid leukemias

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4
Q

B lymphoid leukemias include

A 
B- CLL
B- prolymphocytic leukemia
Hairy cell leukemia
Plasma cell leukemia
Leukemic phase of indolent non hodgkins lymphoma
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5
Q

T lymphoid leukemias

A 
T-CLL
T prolymphocytic leukemia
sezary syndrome
Adult T cell leukemia
Large granular lymphocytic leukemia
Large cell lymphoma
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6
Q

B CLL is commonest in this age group

A

45-70

Late in life, has familial tendency

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7
Q

B-CLL acounts for this percentage of leukemias

A

25%

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8
Q

M TO F ratio in B-CLL

A

2;1

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9
Q

B-cll characterised by

A

progressive accumulation of immunologically incompetent lymphocytes

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10
Q

B-CLL starts in

A

marrow and lymph nodes and extends to hematopoietic organs

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11
Q

Bone marrow progression is

A

interstitisl
nodular
diffuse

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12
Q

Aetiopathogenesis of CLL

A

Arise from lymphocytes with CD 23, CD 25, CD 27 markers

Cytopenias

Autoimmune phenomena with AIHAs or ITP

Up regulation of anti apoptotic proteins, MCL 1, Survivin

Bone marrow aplasia

anemia

CLL become large ce;; lymphoma- richters syndrome

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13
Q

this is usually expressed in CLL cells

A

TNF alpha

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14
Q

Common presentation in CLL

A

incidental discovery
superficial lymph node involvement
anemia
splenomegaly

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15
Q

Occasional presentation of CLL

A 
Haemorrhage
AIHA
Mediastinal pressure/obstruction
Reduced gamma globulin
Thrombocytopenia
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16
Q

Diagnosis of CLL

A

FBC
Imaging
immunogenetics, cytogenetics
Bone marrow trephine

17
Q

Binnet staging

A

A- 0-2 lymphoid organs
B- more than 2 areas with Hb less than 10 and platelets above 10010^9
C-Hb less than 10 and platelet less than 10010^9

18
Q

Diagnostic criteria for CLL

A

Monoclonal lymphocyte count greater than 5*10^9/L

CLL phenotype CD5 AND CD23+,CD 19+,CD 209

Weak or negative FMC7 and CD79b

19
Q

Prognostic factors for CLL

A 
Median survival 7yrs
Binnet B is intermediate risk
Binnet C is high risk
Females survive longer
TP53 mutation , del17p13,11q32 associated with poor thinking
20
Q

Del13q14 confers

A

Good prognosis

21
Q

Management of CLL

A

Supportive - treat anemia, thrombocytopenia, severe autoimmune conditions, infections

Specific- chemotherapy

Binnet A may not need treatment for awhilw

Chemotherapy alone or in combination with steroids

22
Q

Chemotherapy drugs

A

Chlorambucil
Fludarabine
Cyclophosphamide
Cyclophosphamide+ Vincristine+ prednisolone
Cyclophosphamide + Vincristine+ Andriamycine+ prednisolone (chop)
Rituximab

23
Q

Cytopenia causes in CLL

A

Marrow suppression- immunologically immune lymphocytes

Hypersplenism

Autoimmune phenomena

Haematology (29 decks)

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