Chronic lymphocytic leukemia

NEET PG Pathology
#1

  1. Composed of monomorphic B lymphocytes in:
    peripheral blood
    bone marrow
    lymphoid organs

  2. Incidence:
    Age: 50-60
    Sex: M>F

3)Peripheral smear:
RBC’S: Normocytic normochromic anaemia
WBC’S : Total leukocyte count increased

4)Platelet count:
Initially normal
Decreased due to bone marrow infiltration and autoimmune destruction associated with hypersplenism

  1. Hemoglobin
    <13gm/dL
    <10gm/dL with disease progression
    Due to marrow failure and associated autoimmune hemolysis

  2. Bone marrow
    Cellularity: Hypercellular marrow
    Erythropoiesis, myelopoiesis and megakaryopoiesis normal

  3. Special tests:
    Coombs test: 15-20 % positive direct
    Immunophenotype: Tumor cells express CD19 and CD20

  4. Clinical features:
    25% asymptomatic
    Fatigue, malaise, weight loss, anorexia
    Splenomegaly
    Generalized lymphadenopathy
    Hypogammaglobulinemia