Chronic Lymphocytic Leukemia


Clonal disorder of a pluripotent stem cell.

Signs & Symptoms

Symmetrical enlargement of cervical, axillary / inguinal lymph nodes. The nodeas are discrete and non-tender. Features of anemia and thrombocytopenia may be present.

Risk Factors

Most common between 60 – 80 years old and male to female ratio of 2:1. Common in the Western world.


Relatively mature B cell with weak surface expression of IgM / IgD cells accumulate in the blood, bone marrow, liver, spleen and lymph nodes as a result of prolonged lifespan with impaired apoptosis.

Peripheral blood characteristics

Lymphocytosis with small lymphocytes. Smudge or smear cells may be present. Normochormic normocytic anemia due to marrow infiltration or hypersplenism.

Bone marrow characteristics

Lymphocytosis, with nodular, diffuse or interstitial involvement by lymphocytes.

Important investigations & related results

Immunophenotyping will show B cells with CD19+, Cd5+, CD23+, CD79b- and FMC7-. Reduced serum immunoglobulin concentration. Cytogenetics will reveal deletion of 13q14, trisomy 12, deletions at 11q23, structural abnormalities of 17p involving the p53 gene.


Rai (0 – IV) and Binet (A-C)

Treatment & management

Symptomatic, chemotherapy (e.g. chlorambucil), purine analogues, monoclonal antibodies and corticosteroids.

Peripheral blood smear in CLL

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