78 Chronic Lymphocytic Leukemia (CLL)

Michelle To and Valentin Villatoro

Cell Features:1-4

Abundant small mature small lymphocytes

Scant Cytoplasm

Condensed/clumped chromatin (often described as “soccer ball” or “parched earth” appearance)

 

Cause:1-4

A mature B cell neoplasm with no specific agent or cause. Cytogenetic findings show relation to trisomy 12 and other chromosomal deletions.

 

Age group affected: Mainly older adults >50 years old.1,5,6

 

Laboratory Features for CLL:1,2,6

CBC:

Normochromic, Normocytic Anemia

Normal to Decreased reticulocyte count

Neutropenia

Thrombocytopenia

PBS:

Small mature lymphocytes

Presence of smudge cells

Platelet and granulocyte morphology is normal

BM:

Lymphocytic infiltration, reduced numbers of normal hematopietic cells

Immunologic markers:

CD5, CD19, CD20, CD23

Other useful tests:

FISH

PCR

Associated with hypogammaglobulinemia

 


References:

1. Holmer LD, Bueso-Ramos CE. Chronic lymphocytic leukemia and related lymphoproliferative disorders. In: Clinical hematology and fundamentals of hemostasis. 5th ed. Philadelphia: F.A. Davis Company; 2009. p. 440-65.

2. Czader M. Mature lymphoid neoplasms. In: Rodak’s hematology clinical applications and principles. 5th ed. St. Louis, Missouri: Saunders; 2015. p. 619-41.

3. Kipps TJ, Stevenson FK, Wu CJ, Croce CM, Packham G, Wierda WG, et al. Chronic lymphocytic leukaemia. Nat Rev Dis Prim [Internet]. 2017 Jan 19 [cited 2018 Jun 27];3:16096. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336551/

4. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. editors. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues Volume 2. 4th ed. International Agency for Research on Cancer (IARC); 2008.

5. McKenzie SB. Introduction to hematopoietic neoplasms. In: Clinical laboratory hematology. 3rd ed. New Jersey: Pearson; 2015. p. 424-45.

6. Turgeon ML. Malignant myeloid and monocytic disorders and plasma cell dyscrasias. In: Clinical hematology: theory and procedures. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1999. p. 275-92.

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A Laboratory Guide to Clinical Hematology by Michelle To and Valentin Villatoro is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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