Canterbury DHB
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.
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.
Topic Code: 5499