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General Medicine

Leukemia, Chronic Lymphocytic

Reviewed 06/2018
 


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 s...

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 Inves...

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 guideli...

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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Related Images
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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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