Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • abdominal fullness or discomfort
  • splenomegaly

Other diagnostic factors

  • weakness and fatigue
  • pallor and petechiae
  • fever
  • recurrent infections
  • hepatomegaly
  • superficial and deep lymphadenopathy
  • neurologic findings
  • associated systemic immunologic disorders

Risk factors

  • middle age
  • environmental exposures
  • genetic predisposition
  • male gender
  • white ancestry
  • Epstein-Barr virus
  • infectious mononucleosis
  • western hemisphere location

Diagnostic investigations

1st investigations to order

  • CBC
  • peripheral blood smear
Full details

Investigations to consider

  • bone marrow aspiration or biopsy
  • immunophenotyping
  • flow cytometry
  • tartrate-resistant acid phosphatase (TRAP)
  • CT of abdomen
Full details

Emerging tests

  • genetics/molecular testing
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Associate Professor

USF Center for Comparative Effectiveness Research and Evidence Based Medicine

Department of Internal Medicine, College of Medicine

Moffitt Cancer Center & Research Institute, Department of Health Outcomes & Behavior

University of South Florida

Tampa

FL

Disclosures

AK declares that he has no competing interests.

Professor of Medicine and Oncology

Moffitt Cancer Center & Research Institute

Department of Blood and Marrow Transplantation

Department of Oncologic Sciences

University of South Florida College of Medicine

Tampa

FL

Disclosures

MKD declares that he has no competing interests.

Dr Ambuj Kumar and Dr Mohamed Kharfan-Dabaja would like to gratefully acknowledge Dr Benjamin Djulbegovic, a previous contributor to this monograph. BD declares that he has no competing interests.

Peer reviewers VIEW ALL

Consultant Haemato-Oncologist

Section of Haemato-Oncology

Brookes Lawley Institute of Cancer

Sutton

UK

Disclosures

DC declares that he has no competing interests.

Clinical Professor of Medicine

University of Texas Health Science Center San Antonio

San Antonio

TX

Disclosures

RL declares that he has no competing interests.

Chief Fellow

Section of Hematology and Oncology

Department of Internal Medicine

Wake Forest University Baptist Medical Center

Winston-Salem

NC

Disclosures

RC declares that she has no competing interests.

Consultant Hematologist

The Royal Marsden Hospital

Sutton

Surrey

UK

Disclosures

CD declares that she has no competing interests.

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