病史和体格检查

关键诊断因素

常见

shortness of breath and fatigue

Due to anaemia caused by CLL, or due to autoimmune haemolytic anaemia (a complication of CLL occurring in 5% to 10% of patients).[34][35]

Shortness of breath may be present in patients with advanced disease.

lymphadenopathy

Painless lymphadenopathy is common.[3]

Presence of lymphadenopathy can guide staging and treatment. See Diagnostic criteria and Management sections.

splenomegaly

Present in approximately 50% of cases.[4]

Presence of splenomegaly can guide staging and treatment. See Diagnostic criteria and Management sections.

不常见

hepatomegaly

Present in approximately 14% of cases.[4]

Presence of hepatomegaly can guide staging and treatment. See Diagnostic criteria and Management sections.

其他诊断因素

常见

presence of risk factors

Risk factors include age over 60 years, male sex, white ethnicity, and positive family history.

不常见

B symptoms

A minority of patients (approximately 10%) present with B symptoms (fever, drenching night sweats, unintentional weight loss) or other symptoms (e.g., chills, fatigue).[4]​

Presence of B symptoms can guide treatment. See Management section.

recurrent infections

Due to dysfunctional lymphocytes and subsequent hypogammaglobulinaemia.

May be present in patients with advanced disease.

epistaxis

Sign of thrombocytopenia.

May be present in patients with advanced disease.

pallor

Sign of anaemia.

petechiae

Sign of thrombocytopenia.

危险因素

强

age over 60 years

Median age at diagnosis in the US is 70 years; approximately 69% of diagnoses occur in people aged ≥65 years.[7]

family history of CLL

Approximately 5% to 10% of cases are familial.[15][16]

One Swedish registry study reported a 7.5-fold increased risk for CLL in first-degree relatives of those with CLL.[31]

弱

male sex

CLL is more common in men than in women (6.3 vs. 3.3 new cases per 100,000, respectively; 2017-2021 age-adjusted US data).[7]

white ethnicity

CLL is more common in white people than people of other races/ethnicities.[7]

In the US, incidence in non-Hispanic white people is 7.8 per 100,000 males and 4.1 per 100,000 females, respectively (2017-2021, age-adjusted US data).[7]

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