Leukaemia - Chronic Lymphocytic Leukaemia

Question 1

What is Chronic Lymphocytic Leukaemia?

Answer 1

Chronic (monoclonal) proliferation of a single type of well-differentiated lymphocyte, usually B-lymphocytes.

Question 2

Clinical Presentation of CLL.

Answer 2

Usually Asymptomatic.

Question 3

Investigations of CLL (3).

Answer 3

1. Bloods : Incidental Lymphocytosis.
2. Blood FIlm : Smear/Smudge Cells.
3. Immunophenotyping - Key Investigation.

Question 4

What are smear/smudge cells caused by?

Answer 4

Process of preparing the blood film causes aged/fragile WBCs to rupture and leave a smudge.

Question 5

Management of CLL.

Answer 5

Chemotherapy Regimens.

Question 6

Complications of CLL (4).

Answer 6

1. Anaemia.
2. Hypogammaglobulinaemia (Recurrent Infections).
3. Warm AIHA.
4. Richter’s Transformation.

Question 7

What is Richter’s Transformation?

Answer 7

Leukaemia cells enter the lymph node and change into a high-grade fast-growing NHL.

Question 8

Clinical Features of Richter’s Transformation (3).

Answer 8

Sudden Deterioration in Health :
1. Lymph Node Swelling.
2. Fever without Infection.
3. Constitutional Symptoms.