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General Medicine

Leukemia, Chronic Lymphocytic

Jan Cerny, MD, PhD and Amy E. Pratt, DO Reviewed 06/2019
 


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). 

MEDICATION

First Line

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, 2016. CA Cancer J Clin.  2016;66(1):7–30. [View Abstract on OvidMedline]
2
Burger JA, Tedeschi A, Barr PM, et al; and RESONATE-2 Invest...

ADDITIONAL READING

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

  • National Comprehensive Cancer Network guidelin...

CODES

ICD10

  • C91.10 Chronic lymphocytic leukemia of B-cell type not achieve remission

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

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

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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Cleaved cell (butt) CELL TYPE: Lymphocyte DESCRIPTION: Small, mature lymphocyte with cleaved nucleus CLINICAL CONDITIONS: Pertussis (Whooping cough) Lymphoma CLL
Cleaved cell (butt) CELL TYPE: Lymphocyte DESCRIPTION: Small, mature lymphocyte with cleaved nucleus CLINICAL CONDITIONS: Pert...
Chronic Lymphocytic Leukemia (CLL) White cells Increased to 20 to 200 X 10 9 /L Absolute lymphocytosis Typical, small lymphocytes with a hypermature appearing nucleus Smudge cells present Less than 10% prolymphocytes Larger cells may be seen in Richters Syndrome Red cells Normocytic, normochromic anemia Platelets Normal Often decreased with disease progression Bone marrow Replacement by lymphocytes Less than 10% prolymphocytes Immunophenotype CD5, CD19, CD23, CD79a...
Chronic Lymphocytic Leukemia (CLL) White cells Increased to 20 to 200 X 10 9 /L Absolute lymphocytosis Typical, small lymphocytes with ...
Chronic Lymphocytic Leukemia (CLL) White cells Increased to 20 to 200 X 10 9 /L Absolute lymphocytosis Typical, small lymphocytes with a hypermature appearing nucleus Smudge cells present Less than 10% prolymphocytes Larger cells may be seen in Richters Syndrome Red cells Normocytic, normochromic anemia Platelets Normal Often decreased with disease progression Bone marrow Replacement by lymphocytes Less than 10% prolymphocytes Immunophenotype CD5, CD19, CD23, CD79a...
Chronic Lymphocytic Leukemia (CLL) White cells Increased to 20 to 200 X 10 9 /L Absolute lymphocytosis Typical, small lymphocytes with ...
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