Chronic Lymphocyctic Leukaemia

• What is chronic lymphocytic leukaemia?


  Haematological malignancy

  Characterised by accumulation of mature monoclonal B lymphocytes in blood, bone marrow & lymphoid tissue

  Abnormal B cells are often slow growing & crowd out healthy blood cells
• CLL is most common on 60-70 yrs old.
• What the RFs of chronic lymphocytic leukaemia?


  Genetics

  FHx

  Immunocompromised
• What are the signs & symptoms of chronic lymphocytic leukaemia?


  Often asymptomatic

  Non-tender symmetrical lymphadenopathy

  Hepatosplenomegaly

  B symptoms

  • weight loss
  • night sweats
  • fever

  Infection

  Anaemia

  Bleeding
• What are the DDx of chronic lymphocytic leukaemia?


  Hairy cell leukaemia -> another mature B cell leukaemia

  Small lymphocytic lymphoma

  Infections
• What is shown in the image?

  Blood film in CLL

  
• What are the Inx for chronic lymphocytic leukaemia?


  Obs

  Full Hx & examination

  Bloods (inc blood film)

  Immunophenotype
• What is commonly found in bloods in CLL?


  Lymphocytosis

  Blood film -> smudge cells
• What is the management of chronic lymphocytic leukaemia?


  Watch & wait in early disease

  Chemotherapy

  Corticosteroids

  Allogenic stem cell transplantation
• What are the possible complications of chronic lymphocytic leukaemia?


  Infections

  Transformation to diffuse large B cell lymphoma

  Autoimmune haemolytic anaemia