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21 Cards in this Set
- Front
- Back
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What is the most common form of leukemia in the US?
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Chronic Lymphocytic Leukemia, at 30%
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What is the specific cell type in CLL?
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Small clonal B-Cells
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Who is at risk for CLL?
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Most diagnoses are in the elderly, but middle age as well.
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What are the presenting symptoms of CLL?
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Often asymptomatic. Others include
* Swollen lymph node (nodal infiltration) * LUQ discomfort (splenic infiltration) * Early satiety |
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How does CLL present in the peripheral blood?
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CLL presents with a lymphocyte count >5K. Tumor cells appear similar to normal, mature lymphocytes.
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What is the appearance of the marrow in CLL?
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CLL marrow aspirates appear hypercellular, with extensive infiltration (>30%) of mature lymphocytes.
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What disease is represented on this peripheral blood smear?
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Chronic Lymphocytic Leukemia
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What tissues are commonly involved in CLL?
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Lymph nodes
Spleen and Liver |
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On nodal biopsy, what histologic pattern suggests CLL?
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Diffuse pattern of well-differentiated small lymphocytes. CLL is a.k.a "Small Lymphocytic Lymphoma"
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What is required to diagnose CLL?
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Demonstration of a persistent, mature, monoclonal lymphocytosis in patients over the age of 50.
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What serum protein is LOW in CLL?
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Gamma globulins are low in CLL (hypogammaglobulinemia), leaving pts prone to infection.
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What are the clinical staging criteria for CLL?
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0) Lymphocytosis (mean survival 12 y)
1) +Lymphadenopathy (10y) 2) +Hepatosplenomegaly (8y) 3) +Anemia (1-2y) 4) +Thrombocytopenia (1-2y) |
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What is the therapeutic strategy for CLL?
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CLL is not cureable with chemotherapy.
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What is the WBC count at which CLL chemotherapy should begin?
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In CLL, lymphocytosis does not result in leukostasis and is therefore not an indicator for treatment.
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What are the clinical indicators for treatment in CLL?
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1) Symptomatic, progressive adenopathy or splenomegaly
2) Progressive anemia or other cytopenia 3) "B" Symptoms (fever, chills, weight loss) |
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What are "B SYMPTOMS?"
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Constitutional symptoms such as fever, weight loss and chills.
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What is the chemo standard of care for CLL?
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Treatment is Palliative:
* Fludarabine * +/- Cyclophosphamide * +/- Rituximab |
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When are corticosteroids indicated in CLL?
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With CLL-associated autoimmunes, such as autoimmune hemolytic anemia, and immune thrombocytopenia
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When are CLL patients candidates for stem cell transplant?
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When their cancer is resistant to Fludarabine chemotherapy.
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PROGNOSIS ACCORDING th stages
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stage 0 >> lymphocytosis only>> prognosis is good
stage I>> lymph0cytosis + adenopathy>> fair stage II>> splenomegaly>> fair stage III >>anemia>>intermediate stage IV ... thrombocytopenia >>poor |
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what is the principal case of death in CLL
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infection
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