CLL as a cause of a persistent increase in absolute numbers of lymphocytes

on 7.2.09 with 0 comments

  • CLL is the most indolent of the leukemias

  • 25% of leukemias, seen in people > 50 YOA, males 2X more

  • Most are of B cell type and express small amounts of IgM or IgD with restriction to or light chains (they are monoclonal)

  • They are mature B cells and as such will express pan-B cell Ags like CD19 and CD20 but not the early-B cell Ags like CD10 (common ALL Ag, CALLA) or TdT

  • CD5 (a T-cell Ag) is expressed on some B cells

  • T cell CLL is rare (<>

  • Associated with bcl-1 and bcl-2 mutations (sometimes)

  • Nonspecific C/S; generalized lymphadenopathy and hepatosplenomegaly in 50-60% of cases

  • Evan’s syndrome

    • Formation of Abs against RBCs and platelets in 10-15% of CLL patients

    • Get an autoimmune hemolytic anemia and/or thrombocytopenia

  • Survival depends on how long disease went undiagnosed; worst prognosis with anemia or thrombocytopenia

  • Transformation to acute leukemia with blast crisis rare; more common to progress to prolymphocytic leukemia (more aggressive than CLL but not as aggressive as an acute leukemia)

Category: Medical Subject Notes , Pathology Notes



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