CLL- Krafts Flashcards
Chronic Lymphoproliferative Disorders
Things you must know!
- Malignant proliferation of lymphocytes in blood, bone marrow
- Many disorders, CLL most important
- Only in adults
- Long course, indolent but incurable
Chronic Lymphocytic Leukemia
Things you must know!
- Small, mature lymphcytes
- =small lymphocytic lymphoma
- B-cell, but CD5+ (weird!)
- Long but inexorable course
Clinical finding in CLL
- Older >40
- Asymptomatic at first
- Later, organ infiltration
Immunophenotype of CLL?
What is it positive and negative for?
-
Positive for:
- B cell antigen
- T cell antigen (CD5)
-
Negative for:
- Tdt
Lab finding in CLL?
- High WBC count
- Hypogammaglobulinemia
Pathophysiology of CLL?
bcl-2 gene rearrangement –> expressed all the time –> immortal cells
normal bcl-2 prevents apoptosis
Treatment?
Prognosis?
What is death usually from?
Treatment: Conservative, reduce organomegaly and infections
Prognosis: Mean survival–9 years
“counts” of normal cells (Hbg, platelet)
Adenopathy, BM pattern, chrmosomal abnormalities
Death from infection
Hairy Cell Leukemia
Things you must know!
- Hairy cells (duh)
- Splenomegaly without lymphadenopathy
- Pancytopenia
- TRAP +
Clinical Findings in HCL?
- Older (>40)
- M:F = 5:1
- Big spleen but no lymphadenopathy
Special Studies in HCL
Cytochemistry –>
Immunophenotype –>
Cytochemistry –> TRAP + (stains mostly just hairy cells)
Immunophenotype –>
Postive for B cell antigens, CD25, CD 11c
Negative for CD5 (+ in CLL)
Lab findings in HCL?
Pancytopenia (usually)
Monocytopenia (always)
HCL treatment and prognosis?
Treatment: chemo
Prognosis: GOOD!
Prolymphocytic Leukemia
Things you must know!
- Prolymphocytes
- Splenomegaly without lymphadenopathy
- Rare
- Aggressive :(
PL findings
Clinical?
Lab?
- Clinical:
- Splenomegaly without lymphadenopathy
- Aggressive
- Lab:
- high WBC
- Low Hgb
- Low platelet count
Large Granulated Lymphocyte Leukemia
Things you must know!
- Large granulated lymphocytes
- T-cells
- Neutropenia
- Long survival
