21) CLL Flashcards by Samantha Boyer

patients with widespread ——— often have worse CLL prognosis

lymphoma

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the ann arbor staging system is used for…

malignant lymphoma

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CLL/SLL

chronic lymphocytic leukemia/small lymphocytic leukemia

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different clinical manifestations of one disease entity

CLL/SLL

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CLL presents with…
SLL presents with…

PB lymphocytosis
lymphadenopathy

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sustained absolute monoclonal lymphocytosis
(>5 x 10^3)

CLL/SLL

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lymphocytosis + smudge cells

CLL/SLL

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if lymphocytosis is <5 x 10^3, it’s not CLL, its…

B-cell monoclonal lymphocytosis
no chemo yet

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CD5
CD20
CD23
CD200
LEF-1 +

CLL/SLL

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CD5
CD23=
FMC-7 +
cyclin D1 +

mantle cell lymphoma

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CLL/SLL must be distinguished from…

how?

mantle cell lymphoma

MCL is CD23=, FMC-7+, LEF-1=

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t(11;14)

mantle cell lymphoma

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Richter’s transformation

transformation from CLL → aggressive large B-cell lymphoma

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anti-CD20 mAbs

used to tx CLL/SLL

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ibrutinib

used to tx CLL/SLL

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B-PLL

B-cell prolymphocytic leukemia

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B-PLL survival

7.5 months

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> 55% prolymphocytes
marked lymphocytosis

B-PLL

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HCL

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hairy cell leukemia

uncommon B-cell neoplasm more common in males (7:1)

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HCL

lymph disorder
massive splenomegaly
no lymphocytosis
pancytopenia

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HCL

how is HCL different from CLL?

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pancytopenia

other name for MM

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plasma cell neoplasm

M-spike
functional hypogammaglobulinemia
Bence Jones protein

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MM/plasma cell neoplasm

4 types of plasma cell neoplasms

- symptomatic MM - asymptomatic MM (smoldering) - monoclonal gammopathy of undetermined significance - plasmacytoma

M spike >30 g/L no organ/tissue damage BM clonal plasma cells >10%

asymptomatic/smoldering MM

M spike <30 g/L no organ/tissue damage BM clonal plasma cells <10%

MGUS

solitary collection of clonal plasma cells may have M spike

plasmacytoma

**MM** hypercalcemia renal insufficiency anemia lytic bone lesions

MM patients often present with...

pathologic fracture

rouleaux Mott cells flame cells Dutcher bodies PB stains dark blue background (protein)

MM survival (symptomatic)

3-4 years

<65 yo: high-dose chemo + SCT >65 yo: melphalan chemo + prednisone

MM tx

heterogeneous morphology histiocytes, plasma cells, eos mixed in

peripheral T-cell lymphoma

usually CD4+/CD8= complex karyotype

peripheral T-cell lymphoma

marked lymphocytosis skin lesions hepatosplenomegaly variable morphology

peripheral T-cell prolymphocytic leukemia

modest but prolonged lymphocytosis must differentiate from reactive lymphocytosis usually requires evidence of abnormal phenotype/clonality