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Review and new Insights

Chronic lymphocytic leukemia

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Dr. Feroze Momin presents Chronic Lymphocytic Leukemia - Review and new Insights. To read about Dr. Feroze Momin: http://conquercancers.com/ourdoctorso1.html To read about Cancer Treatment Center in Michigan: http://conquercancers.com

Text of Chronic lymphocytic leukemia

  • 1. Review and new Insights

2. Effect of 2 -microglobulin on survival in untreated CLL Years Proportion surviving 16 0 2 4 6 8 10 12 14 1.0 18 0.8 0.6 0.4 0.0 0.2 1.Keating M. Unpublished data. 2. Hallek M, et al.Leuk Lymphoma.1996;22:439-447. 3. Sarfati M, et al.Blood.1996;88:4259-4264. 4. Fayad L, et al.Blood.2001;97:256-263 .Pts Died 2 M 445 53 4.0 3. Effect of 2 -microglobulin on survival in untreated CLL Years Proportion surviving 16 0 2 4 6 8 10 12 14 1.0 18 0.8 0.6 0.4 0.0 0.2 1. Keating M. Unpublished data. 2. Hallek M, et al.Leuk Lymphoma.1996;22:439-447. 3. Sarfati M, et al.Blood.1996;88:4259-4264. 4. Fayad L, et al.Blood.2001;97:256-263.Pts Died 2 M 445 53 4.0 4.

  • Clonal disorder of B and T lymphocytes
    • Elderly patients usually
      • 10% are < 50 yrs
    • 50% are asymptomatic at diagnosis
      • Lymph nodes
      • Splenomegaly
      • Fatigue
      • Infections

5.

  • Symptomatic patients
      • Lymphadenopathy
      • Splenomegaly
      • Anemia
      • Acquired Inhibitorsto VIII/VWF
      • Bruising and bleeding
      • Hypogammaglobulinemia
      • Recurrent infections

6.

  • Sustained lymphocytosis of > 10,000: mature lymphocytes
  • Marrow > 30% lymphs
  • CD 5+ lymphs
  • PBS lymphs> 5000
  • CD19, CD20, CD 23, CD5
  • Kappa or lambda chain (not both)
  • Marrow > 30% lymphs

NCI WG (1986) 7. Diagnosis: NCI vs IWCLL guidelines for CLL 1. Cheson BD, et al.Blood.1996;87:4990-4997. Variable NCI IWCLL Diagnosis Lymphocytes (x 10 9 /L) 5; B-cell Marker (CD19, CD20, CD23) + CD5 10 + B phenotype or bone marrow involved 15,000/mm 3 ) 0 - 150 months(12.5 years) Lymphocytosis plus nodal involvement I A 3 node groups 60-71 months (5-6 years) Anemia (RBCs) III Hgb