Monday 3 - Nikcevich - Chronic Lymphocytic Leukemia

Question 1

commonality, common age, survival

Answer 1

Most common leukemia in adults
Median age diagnosis 65 years
Median survival 9 years

Question 2

absolute lymphocyte count in CLL

Answer 2

> 5000

Question 3

flow cytometry markers in CLL

Answer 3

CD5+CD19+CD20+CD23+

Question 4

flow cytometry markers in Mantle cell lymphoma (nasty NHL) that differ from CLL

Answer 4

CD23- cyclinD1+ are the differences

Question 5

Autoimmune Complications of CLL

Answer 5

AIHA autoimmune hemolytic anemia
Coombs’ positive
Pure red cell aplasia
ITP (idiopathic thrombocytopenic purpura)
Neutropenia
^ retics

Question 6

If you see red cell aplasia in someone without CLL, what are you thinking?

Answer 6

parvovirus

Question 7

What one lab test do you always get with CLL

Answer 7

FISH

Question 8

CD38 - mutated and unmutated prognosis in CLL

Answer 8

unmutated (positive) - poor prognosis

Question 9

ZAP-70+

good or bad in CLL

Answer 9

bad

Question 10

what do you give for CLL that makes some one have “AIDS”

what do you give to help

Answer 10

Pentodtatin - depletes CD4 T-cells well below 200.

Tx: dapsone, acyclovir

Question 11

Smudge cells

Answer 11

in patients with 13q- CLL

good prognostic factor

Question 12

what do prolymphocytes look like?

Answer 12

larger that lymphocytes, a little more cytoplast (robins egg blue cytoplasm)

Question 13

cytogenetics of secondary prolymphocytic leukemia

Answer 13

richter’s transformation

new 17p-

Question 14

what is really expensive but works really well for CLL

Answer 14

Ibrutinib