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23 Cards in this Set
- Front
- Back
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what are the essentials of diagnosis in CLL?
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lymphocytosis >5000/mcl
coexpression of CD19 and CD5 on lymphocytes |
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what is the median age in CLL?
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70 years
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what are other epidemiologic findings in CLL?
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most common leukemia in adults with 30%
90% of cases occurring after age 55 |
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what are common classifications system of CLL?
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Rai classification system (USA)
or Binet (Europe) |
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what is the grading in the Rai classification of CLL?
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stage 0 lymphocytosis only
stage 1 lymphocytosis and lymphadenopathy stage 2 organomegaly stage 3 anemia stage 4 thrombocytopenia |
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what are the definitions of risk groups in CLL?
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Rai stage 0/1 low-risk
Rai stage 2 intermediate risk Rai stage 3/4 high-risk |
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what are particular hematologic phenomena of CLL?
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10% with autoimmune hemolytic anemia
2% with autoimmune thrombocytopenia 5% with transformation of isolated lymph node transformation into an aggressive large cell lymphoma (Richter syndrome) |
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what are the characteristic laboratory findings in CLL?
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lymphocytosis usually greater than 20'000/mcL
hematocrit and platelets usually normal at presentation |
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what is the morphology of the bone marrow in CLL?
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variable infiltration with small (mature) lymphocytes
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what are the immunophenotypic findings in CLL?
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coexpression of the B lymphocyte lineage marker CD19 with the T lymphocyte marker CD5
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in what condition is coexpression of CD19 and CD5 also seen?
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mantle cell lymphoma
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how is CLL distinguished from mantle cell lymphoma?
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cytogenetic studies
CLL with expression of CD23 low expression of surface immunoglobulin and CD20 abscence of overexpression of cyclin D1 |
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what is a frequent immunologic complication of CLL?
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hypogammaglobulinemia in 50%
small amount of IgM paraprotein in some (DD Waldenström macroglobulinemia) |
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what is the differential diagnosis to CLL?
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viral infection and pertussis (Bordetella pertussis)
other lymphoproliferative disorders with splenomegaly and lymphocytosis, such as mantle cell lymphoma, follicular lymphoma, splenic marginal cell lymphoma, hairy cell leukemia, Waldenström macroglobulinemia (lymphoplasmacytic lymphoma) |
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keywords of CLL?
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progressive accumulation of functionally incompetent but mature lymphocytes
chronic course: months to decades! |
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frequency of lymphadenopathy and splenomegaly in CLL?
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50% with lymphadenopathy
25% with splenomegaly |
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what is the grading of CLL in the Binet classification system
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A less than 3 regions affected, Hb>100 g/l, Tc>100 G/l
B 3 or more regions affected, Hb>100 g/l, Tc>100 G/l C Hb<100 g/l or Tc <100 G/l definition of areas: spleen, liver, lymph nodes (axillary, inguinal, cervical) |
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prognosis in CLL?
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very variable, depending on cytogenetics
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what are the treatment principles in CLL?
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palliative,
first-line treatments are FCR (fludarabine/cyclophosphamide with rituximab) or bendamustine (=Ribomustin) another second-line therapy is a monclonal antibody: anti-CD52 alemtuzumab = MabCampath |
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what are other particular findings in CLL?
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increased risk for secondary neoplasms, by the majority solid, such as melanoma, bronchial carcinoma and gastrointestinal neoplasms
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what is the incidence of CLL?
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3-4/100'00
>20/100'000 in people >70 years |
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what are the characteristics of genetic changes in CLL in contrast to most hematological malignancies?
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most with chromosomal deletions or loss of heterozygosity rather than translocations
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what is the cell of origin in CLL?
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naive B cell or memory B cell
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