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Leukemia, Chronic Lymphocytic

Jan Cerny, MD, PhD and Ming-Jin Wang, DO Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Chronic lymphocytic leukemia (CLL) is a monoclonal disorder characterized by a progressive accumulation of mature but functionally incompetent lymphocytes.

  • CLL should be distinguished...

DIAGNOSIS

HISTORY

  • Insidious onset. It is not unusual for CLL to be discovered incidentally (up to 40% of patients are asymptomatic at the time of diagnosis).

  • Others may have the following symptoms:

    • B sym...

TREATMENT

GENERAL MEASURES

  • Patients with CLL with frequent infections associated with hypogammaglobulinemia are likely to benefit from infusions of intravenous immunoglobulin (IVIG).

  • Genetic risk strati...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Patients with low-risk CLL and/or patients in remission: 
  • CBC with differential (lymphocytosis), LDH, and β2-microglobulin every 3 to 6 months

  • Phy...

REFERENCES

1
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin.  2019;69(1):7–34.
2
Woyach JA, Ruppert AS, Heerema NA, et al. Ibrutinib regimens versus chemoimmunotherapy in o...

ADDITIONAL READING

  • Chiorazzi N, Rai KR, Ferrarini M. Chronic lymphocytic leukemia. N Engl J Med.  2005;352(8):804–815.

  • National Comprehensive Cancer Network guidelines: http://www.nccn.org/

  • Shanafe...

CODES

ICD10

  • C91.12 Chronic lymphocytic leukemia of B-cell type in relapse

  • C91.11 Chronic lymphocytic leukemia of B-cell type in remission

  • C91.10 Chronic lymphocytic leukemia of B-cell type not having ach...

CLINICAL PEARLS

  • CLL is the most common form of leukemia in adults in the United States.

  • CLL primarily affects elderly individuals, median age of diagnosis being 70 years. Incidence continues to rise in...

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