Canterbury DHB

Context

Chronic Lymphocytic Leukaemia/Small Lymphocytic Lymphoma (CLL/SLL)

In This Section

Overview

Clinical Features

Laboratory Diagnosis

Investigations for the New Patient With CLL

Management of B-CLL

Monitoring and Supportive Care

Relapsed or Refractory Patients

Overview

B cell chronic lymphocytic leukaemia is a neoplasm of small, mature B-lymphocytes involving the peripheral blood, bone marrow, and lymph nodes which usually expresses CD5 and CD23. Small lymphocytic lymphoma is morphologically and immunophenotypically identical to B-CLL but without leukaemic involvement.

B-cell CLL is the commonest form of leukaemia in USA and Europe, where it mainly affects the over-50 year old population (median 65 years).

CLL pursues an extremely variable course with survival ranging from months to decades; if CLL cells have mutated immunoglobulin genes, this confers an excellent prognosis.

Treatment is not offered to CLL patients unless there is evidence of advanced or progressive disease. Various forms of allografting are the subject of current trials, but in general the aim of treatment is to control the disease while avoiding excessive toxicity.

Further Reading

Oscier, D., C. Dearden, et al. (2012). "Guidelines on the diagnosis, investigation and management of chronic lymphocytic leukaemia." Br J Haematol 159(5): 541-564.

Hallek, M. (2013). "Chronic lymphocytic leukemia: 2013 update on diagnosis, risk stratification and treatment." Am J Hematol 88(9): 803-816.

Clinical Features

Most patients are asymptomatic at diagnosis. Others present with infections, anaemia, thrombocytopenia, lymphadenopathy and hepatosplenomegaly. Some patients present with no obvious blood involvement but with enlarged lymph nodes. Extension to blood and marrow occurs eventually.

About this Canterbury DHB document (5499):

Document Owner:

Andrew Butler (see Who's Who)

Issue Date:

September 2018

Next Review:

September 2021

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 5499