CLL Flashcards
Tests to order if anemia is present
DAT, haptoglobin, reticulocyte count
what type of lymphocytes produce antibody molecules that can latch on and destroy invading viruses or bacteria.
B Cells
what type of lymphocytes are direct fighters of foreign invaders and also produced cytokines, which are biological substances that help activate other parts of the immune system?
T Cells
a mature B cell neoplasm characterized by a progressive accumulation of monoclonal B lymphocytes.
CLL
term CLL is used when the disease manifests primarily in the blood, whereas what term is used when involvement is primarily nodal?
small lymphocytic lymphoma (SLL)
one study demonstrated that up to 17 percent of first-degree family members of patients with CLL were found by flow cytometry to have what known precursor to CLL?
monoclonal B cell lymphocytosis (MBL)
The most common abnormal finding on physical examination of the patient with CLL/SLL is _______ present in 50 to 90 percent of patients among various series
lymphadenopathy
what are the most common sites for lymphadenopathy in CLL?
Cervical, supraclavicular, and axillary lymph nodes are affected most commonly.
T or F: an enlarged spleen in CLL/SLL is usually painful and tender to palpation, with a sharp edge and a smooth firm surface.
F: an enlarged spleen in CLL/SLL is usually painless and nontender to palpation
what is the name of the skin manifestions of CLL that most often involve the face and can manifest as macules, papules, plaques, nodules, ulcers, or blisters.
leukemia cutis. Involvement can be confirmed by biopsy of lesional skin.
the development of an aggressive large-cell lymphoma in the setting of underlying chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)
Richter transformation
What is the incidence of Richter transformation (RT) from chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) ?
variously estimated at 2 to 9 percent
Historically, Richter transformation (RT) has been associated with a dismal prognosis, with median survivals of …
five to eight months
In Richter transformation, Patients with an ECOG performance status <1 who did not have evidence of TP53 disruption and achieved a CR with induction therapy had the best outcomes with a five-year survival rate of
70 percent
a key component to the diagnosis of CLL
Immunophenotypic analysis, usually by flow cytometry
at what level WBC count do the UpToDate authors say they’ve observed hyperviscosity syndrome?
total WBC counts as low as 250 x 109/L
what lab test has is helpful to determine the chance CLL will be complicated by autoimmune hemolytic anemia?
The DAT status was able to correctly predict the development of AIHA in 83 percent of cases with a positive predictive value (chance that a DAT-positive patient will develop AIHA) of 28 percent and a negative predictive value (chance that a DAT-negative patient will remain free of AIHA) of 93 percent.
what is another name for hypogammaglobulinemia?
Common variable immunodeficiency (CVID) is a primary immunodeficiency disorder characterized by impaired B cell differentiation with defective immunoglobulin production.
what are some common, nondiagnostic lab abnormalities seen in CLL?
There are no characteristic abnormalities in blood chemistry, but elevated levels of serum lactate dehydrogenase (LDH) and beta-2 microglobulin were found in approximately 60 percent in one series of patients with progressive or advanced CLL entering a therapeutic trial [73]. Elevations of uric acid, hepatic enzymes (ALT or AST) and, rarely, calcium may also be observed.
if a patient has a b lymphocyte count of less than 5000/microL [5 x 109/L], and no lymphadenopathy, hepatosplenomegaly, disease-related cytopenias, or disease-related symptoms, what are they diagnosed with?
monoclonal B cell lymphocytosis
patients with clonal B lymphocytes with an absolute lymphocyte count (ALC) <5000/microL [5 x 109/L], and with nodal, splenic, or other extramedullary involvement, without cytopenias due to bone marrow infiltration, are diagnosed with what?
with nodal, splenic, or other extramedullary involvement, without cytopenias due to bone marrow infiltration, are diagnosed with SLL
patients with clonal B lymphocytes with an absolute lymphocyte count (ALC) <5000/microL [5 x 109/L] and one or more cytopenias due to bone marrow infiltration with typical monoclonal lymphocytes are diagnosed with
CLL
often suspected based on the presence of circulating lymphocytes with cytoplasmic projections
hairy cell leukemia
in the differential of CLL: the second most common subtype of non-Hodgkin lymphoma (NHL) and is the most common of the clinically indolent NHLs, defined as those lymphomas in which survival of the untreated patient is measured in years.
follicular lymphoma
