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Flashcards in CLL Deck (22)
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1

What category does Chronic Lymphocytic Leukemia fall into??

Chronic Lymphoproliferative Disorders

2

What must you know about chronic lymphoproliferative disorders

-Malignant proliferation of lymphocytes in blood, bone marrow
-Many disorders; CLL most important
-Occur ONLY in adults
-Long course; indolent (not very rapidly dividing) but incurable
-Can’t really do bone marrow transplant (where you expect to cure the patient — but you might be able to do allogenic transplant) —> cancer could just hang out in the lymph nodes

3

What things should you know about chronic lymphocytic leukemia?

-Small, mature lymphocytes
-= small lymphocytic lymphoma
-B-cell, but CD5+ (weird!)
-Long but inexorable course

4

What are the clinical findings in CLL?

-Older
-Asymptomatic at first
-Later, organ infiltration

5

What is the immunophenotype for CLL (EXAM!) ?

Positive: B-cell antigens, T-cell antigen (CD5)!
Negative: TdT

6

What are the laboratory findings in CLL?

-WBC high or really really high
-Hypogammaglobulinemia (causes infection bc they can’t make Ig/antibodies like they need to)

7

What is the pathophysiology of CLL?

-bcl-2 gene rearrangement
-normal bcl-2 prevents apoptosis

8

How to treat CLL?

-Conservative
-Reduce organomegaly, infections (vaccinate, etc.)

9

What is the prognosis of CLL?

-"Counts" adenopathy
-BM pattern, chromosomal abnormalities
-Mean survival: 9 years
-Death usually from infection

10

What things MUST you know about Hairy Cell Leukemia? (EXAM)

-Hairy cells
-Splenomegaly (HUGE SPLEEN) without lymphadenopathy
-Pancytopenia
-TRAP +

11

What are the clinical findings of HCL?

-Older (>40)
-M:F = 5:1
-Big spleen but no lymphadenopathy

12

What are some special studies in HCL?

1. Cytochemistry
-TRAP +
2. Immunophenotype (replacing cytochemistry)
-Positive for B-cell antigens, CD25, CD11c
-Negative for CD5

13

What are laboratory findings in HCL?

-Pancytopenia (usually)
-Monocytopenia (always) = almost never any monocytes around

14

What is the treatment for HCL?

Chemotherapy

15

What is the prognosis for HCL?

Good!!

16

What things MUST you know about prolymphocytic leukemia?

-Prolymphocytes
-Splenomegaly without lymphadenopathy
-Rare
-Aggressive

17

What are the clinical findings in PL?

-Splenomegaly without lymphadenopathy
-Aggressive

18

What are the laboratory findings in PL?

-VERY high WBC
-High Hgb
-Low platelet count

19

What MUST you know about Large Granulated Lymphocyte Leukemia?

-Large granulated lymphocytes
-T-cell
-Neutropenia
-Long survival

20

What are the clinical findings in LGL?

-Infections (from neutropenia)
-Long survival

21

What is the immunophenotype in LGL?

-T-cell

22

What are the laboratory findings in LGL?

-Modest high WBC
-Neutropenia