Monday 3 - Nikcevich - Chronic Lymphocytic Leukemia Flashcards
commonality, common age, survival
Most common leukemia in adults
Median age diagnosis 65 years
Median survival 9 years
absolute lymphocyte count in CLL
> 5000
flow cytometry markers in CLL
CD5+CD19+CD20+CD23+
flow cytometry markers in Mantle cell lymphoma (nasty NHL) that differ from CLL
CD23- cyclinD1+ are the differences
Autoimmune Complications of CLL
AIHA autoimmune hemolytic anemia Coombs’ positive Pure red cell aplasia ITP (idiopathic thrombocytopenic purpura) Neutropenia ^ retics
If you see red cell aplasia in someone without CLL, what are you thinking?
parvovirus
What one lab test do you always get with CLL
FISH
CD38 - mutated and unmutated prognosis in CLL
unmutated (positive) - poor prognosis
ZAP-70+
good or bad in CLL
bad
what do you give for CLL that makes some one have “AIDS”
what do you give to help
Pentodtatin - depletes CD4 T-cells well below 200.
Tx: dapsone, acyclovir
Smudge cells
in patients with 13q- CLL
good prognostic factor
what do prolymphocytes look like?
larger that lymphocytes, a little more cytoplast (robins egg blue cytoplasm)
cytogenetics of secondary prolymphocytic leukemia
richter’s transformation
new 17p-
what is really expensive but works really well for CLL
Ibrutinib