Chronic Lymphocytic Leukaemia Flashcards
Define Chronic Lymphocytic Leukaemia (CLL)?
Characterised by progressive accumulation of functionally incompetent lymphocytes, which are monoclonal in origin. There is an overlap between CLL and non-Hodgkin’s
lymphoma
What is the aetiology of CLL?
Malignant cells may accumulate as a result of their inability to undergo apoptosis
What are the most common chromosomal changes in CLL?
Trisomy 12
11q and 13q deletions
What is the epidemiology of CLL?
90% are > 50 yrs
More common in males
Rare in Asians
What are the presenting symptoms of CLL?
Asymptomatic: 40-50% of cases are diagnosed following routine blood tests
Systemic Symptoms
Symptoms of Bone Marrow Failure
What are the systemic symptoms of CLL?
Lethargy
Malaise
Night sweats
What are the symptoms of Bone Marrow Failure in CLL?
Recurrent Infections
Herpes Zoster Infection
Easy Bruising or bleeding
What are the signs of CLL on physical examination?
Non-tender lymphadenopathy
Hepatomegaly
Splenomegaly
Late stage signs of bone marrow failure
What are some of the late stage signs of bone marrow failure in CLL?
Pallor
Cardiac Flow murmur
Purpura/ecchymosis
What can CLL be associated with?
Autoimmune phenomena such as haemolytic anaemia (warm agglutins) or thrombocytopaenia
What bloods would you do for CLL and what would you see?
FBC: Lymphocytosis Low Hb Low Platelets Low Serum Ig
What could the Low HB be due to in CLL?
Bone marrow infiltration
Hypersplenism
Autoimmune haemolysis
What would you see on a Blood film for CLL?
Small lymphocytes with thin rims of cytoplasm
Smudge Cells
What would you see on a Bone Marrow Aspirate or Biopsy for CLL?
Lymphocytic replacement of normal marrow
What other investigation might you want to do for CLL?
Cytogenetics
