Naive B cells in inter-follicular zones
Cells of origin of CLL and SLL is naive B cells in inter-follicular zones, or post germinal center memory B cell.
CHRONIC LYMPHOCYTIC LEUKEMIA
-
Composed of monomorphic B lymphocytes in:
peripheral blood
bone marrow
lymphoid organs -
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
-
Hemoglobin
<13gm/dL
<10gm/dL with disease progression
Due to marrow failure and associated autoimmune hemolysis -
Bone marrow
Cellularity: Hypercellular marrow
Erythropoiesis, myelopoiesis and megakaryopoiesis normal -
Special tests:
Coombs test: 15-20 % positive direct
Immunophenotype: Tumor cells express CD19 and CD20 -
Clinical features:
25% asymptomatic
Fatigue, malaise, weight loss, anorexia
Splenomegaly
Generalized lymphadenopathy
Hypogammaglobulinemia