1/11 CLL - Corbett

Question 1

CML criteria

Answer 1

elevation in lymphocyte count

Question 2

chronic lymphocytic leukemia

Answer 2

B cell disorder: expansion of mature naive lymphocytes (similar to mantle cells)

most common leukemia in adults (age 72)

• can present as leukemia or lymphoma

progressive accumulation of functionally incompetent lymphocytes, usually monoclonal in origin

cell expresses:

• B cell markers: CD 19, 20, 23
• T cell assoc antigen: CD5 (only other B cell neoplasm that expresses CD5 → mantle cell lymphoma)
• express low amt of surface Ig

lympadenopathy in 50-90% patients

• sheets of small lymphocytes
• effacement of LN architecture
• foci of proliferating cells (“proliferation centers”)
• smudge cells

clinical features

• mostly asymptomatic
• 5-10% have B symptoms
• most common: lymphadenopathy, spenomegaly, hepatomegaly
• hypogammaglobulinemia (2/3)→ incr incidence of autoimmune hemolytic anemia

Question 3

treatment?

Answer 3

only treat symptomatic patients (rare bc disease is so benign)

symptoms mostly related to..

• cytopenias: immune mediated
• autoantibodies (ITP, AHA) → abs dont work well, trigger thrombocytopenia/hemolysis
• infections: deficiency of ab production

5-10% undergo transformation to aggressive lymphoma

Question 4

adult t cell leukemia/lymphoma (acute)

Answer 4

assoc with HTLV1

• Japan, W Africa, Caribbean

skin lesions, LN enlargement, hepatosplenomegaly

“clover leaf cells”

rapidly progressive disease