Chronic lymphocytic leukaemia

An indolent haematological cancer that occurs with increasing age.

Usually presents with absolute lymphocytosis as an incidental finding on routine FBC or with asymptomatic lymphadenopathy.

Diagnosed by FBC with differential, blood smear showing smudge cells, and flow cytometry.

Variable clinical course with most patients experiencing very slow progressive disease.

Clinical and laboratory criteria are used to determine treatment approach and prognosis.

Treatment options include a conservative (watch and wait) approach, chemoimmunotherapy, targeted therapies, and stem cell transplant.

Median survival has improved with the availability of targeted therapies.

Chronic lymphocytic leukaemia (CLL) is an indolent lymphoproliferative disorder in which monoclonal B lymphocytes (>5 x 10⁹/L [>5 x 10³/microlitre]) are predominantly found in peripheral blood.[1]Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016 May 19;127(20):2375-90. http://www.bloodjournal.org/content/127/20/2375.long http://www.ncbi.nlm.nih.gov/pubmed/26980727?tool=bestpractice.com If these cancer cells are found predominantly in lymph nodes, the disorder is called small lymphocytic lymphoma.