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Details

ICM- Hematology and Oncology
Chronic Leukemias (T Pierce)
8
Medical
Professional
11/23/2009

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Cards

Term
epidemiology of CLL
Definition
  • progressive accummulation of immunologically incompetent B cells
  • more so in men than women
  • most common leukemia in Western world
  • median age: 62
  • median survival of about 9 yrs
  • advanced disease has increased morbidity and mortality often from opportunisitic infection
  • acount for 30% of adult leukemias
Term
Structure of CLL cells
Definition
  • differ from normal B cells
    • express CD5
    • lack surface Ig's (hypogammaglobinemia)
  • produce reduced amounts of normal Ig's in response to Ag stimuli
Term
clinical features of CLL
Definition
  • signs
    • lymphadenopathy
    • hepatosplenomegaly
  • variable presentation, asymptomatic, or nonspecific symptoms
    • recurrent infections in 10%
    • usually present for normal check up
Term
CLL lab dx
Definition
  • increase number of mature appearing lymphocytes
  • anemia
  • thrombocytopenia
  • neutropenia
  • bone marrow infiltrate lymph
  • possible hypogammaglobinemia
Term
CLL Rai staging
Definition
  • Rai staging
    • stage 0- lymphocytosis only (survive 12.5 yrs)
    • stage 1- lymphocytosis w/ lymphadenopathy (survive 8.4 yrs)
    • stage 2- splenomegaly (survive 6 yrs)
    • stage 3- anemia (survive 1.6 yrs)
    • stage 4- thrombocytopenia (SEE ABOVE)

We dont treat from lymphadenopathy and below if they are assymptomatic because this is incurable

Term
prognostic factors associated with decreased survival from CLL
Definition
  • advanced stage at dx
  • short lymphocyte doubling time
  • diffuse pattern of marrow infiltration
  • advanced age/males
  • high serum levels of beta 2 microglobulin
  • CLL-PLL
  • abnormal karyotype
Term
chrom abnormalities in CLL and prognosis
Definition
  • 13q deletion (good prognosis)
  • 11q deletion
  • trisomy 12
  • 17p deletion
  • 6q deletion

All the others have bad prognosis

Term
clinical course of CLL
Definition
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