Chronic lymphoid leukaemia Flashcards
who are most affected?
elderly
risk factors
age
7 times more likely if 1st degree relative with it
what cells are affected?
B lymphocytes
symptoms
weight loss night sweats infections bleeding splenomegaly abdominal pain thrombocytopenic rash
which other sites can be affected?
blood bone marrow liver spleen lymph nodes
investigations
blood film bone marrow aspirate coombs test test for tumour protein 53 gene lymph node biopsy
blood film findings
smudge and smear cells
coombs test
direct antiglobulin test - positive indicates diagnosis
test for TP53 gene
deletion indicates worse prognosis and they are less responsive to treatment
diagnostic criteria
> 20% lymphoblasts in bone marrow
5000 B lymphocytes in peripheral blood for >3months with clonality
positive coombs test
positive coombs test
indicates autoimmune haemolytic anaemia
management
stem cell transplant - cure
depends on stage - chemotherapy or steroids
how to manage relapse?
symptomatic treatment only
prognosis
worsened by TP53 gene deletion
long survival initially
relapse = worse prognosis
