Chapter 18 in
haematology (chroinc lymphoid leukaemias)summary
-Chronic lymphocytic
leukaemiaes are characterized by the accumulation of
mature B or T lymphocytes in the blood.
-Individual subtypes are
distinguished on the basis of
morphology,immunophenotype and cytogenetics.
-Chronic lymphocytic
leukaemia (CLL,B cell) represents 90% of cases and has
a peak incidece between 60 and 80 years of age .There is genetic predisposition
to development of the disease.
-Most cases are indenified when a routine blood test is performed the patient can develope
enlarged lymph nodes ,splenomegaly and hepatomegaly.
-Immunosuppression is asignificant problem because of hypogammaglobuilaemia and cellular
immune dysfunction.
-Anaemia may
also develop because of autoimmune haemolysis and bone marrow in filtration.
-Diagnosis is usually performed by immuophenotypic analysis of peripheral blood
which reveals aclonal population of CD5+,CD23+ B cells.
-The best guide to
prognosis is the stage of the disease. In addition , tumours that have acuired
somatic mutations in the immunoglobulin genes have a relatively good prognosis.
-Treatment is usually given only when clinical sympotoms start to
devlope.fludarabine,cyclophosphamide and anti-CD20 monoclonal antibody usually
establish disease remission but are not curative.
-Less common subtype of
chronic lymphiod leukaemias include prolymphocytic leukaemia, hairy cell
leukaemia and T-cell disorders.
From
book: Essentail Haematology A.V.HOFFBRAND,P.A.H.MOSS.6EDITION
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