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Leucemia linfocítica crônica

Última revisão: 19 Mar 2025
Última atualização: 21 Mar 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • dispneia e fadiga
  • linfadenopatia
  • esplenomegalia
  • hepatomegalia
Detalhes completos

Outros fatores diagnósticos

  • presença de fatores de risco
  • sintomas B
  • infecções recorrentes
  • epistaxe
  • palidez
  • petéquias
Detalhes completos

Fatores de risco

  • idade superior a 60 anos
  • sexo masculino
  • etnia branca
  • história familiar de leucemia linfoide crônica (LLC)
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • Hemograma completo com diferencial
  • citometria de fluxo
  • esfregaço de sangue periférico
Detalhes completos

Investigações a serem consideradas

  • microglobulina beta-2 sérica
  • hibridização in situ fluorescente (FISH)
  • Testes moleculares genéticos
  • teste de antiglobulina direto (TAD)
  • imunoglobulinas quantitativas séricas
  • biópsia de linfonodos
  • aspirado de medula óssea e biópsia por trefina
  • TC/PET com fluordesoxiglucose (FDG)-CT
Detalhes completos

Algoritmo de tratamento

AGUDA

fase inicial assintomática (Binet A e B; Rai 0-II)

estádio avançado (Binet C; Rai III-IV) ou com indicações para tratamento (por exemplo, sintomas)

CONTÍNUA

doença recidivante ou refratária

Colaboradores

Autores

Jacqueline C. Barrientos, MD, MS

Associate Professor

Department of Medicine

Zucker School of Medicine at Hofstra/Northwell

CLL Research & Treatment Program

Northwell Health Cancer Institute

Lake Success

NY

Declarações

JCB has been a consultant for Beigene, Abbvie, and AstraZeneca; received honoraria from Janssen; and received research funding from Oncternal, VelosBio, and Pharmacyclics.

Joanna M. Rhodes, MD, MSCE

Assistant Professor

Department of Medicine

Zucker School of Medicine at Hofstra/Northwell

CLL Research and Treatment Program

Northwell Health Cancer Institute

Lake Success

NY

Declarações

JMR has received fees for consulting for Abbvie, Genentech, Pharmacyclics, Beigene, AstraZeneca, Morphosys, Epizyme, ADC Therapeutic, TG Therapeutics, Versatem, SeaGen, and Jannsen. JMR’s institution has received research support from Oncternal Pharmaceutics, Pharmacyclics, Acerta, Loxo Oncology, Velosbios, Abbvie, and AstraZeneca.

Agradecimentos

Dr Jacqueline C. Barrientos and Dr Joanna M. Rhodes would like to gratefully acknowledge Dr Vidhya Murthy, Dr Shankaranarayana Paneesha, and Dr Robert Chen, previous contributors to this topic.

Declarações

VM has received a consultancy fee from Janssen, and a grant from Takeda for the ASH Annual Meeting 2014. SP has received consultancy and speaker fees from Janssen, Gilead, AbbVie, Bristol-Myers Squibb, and Takeda. RC declares that he has no competing interests.

Revisores

Alessandra Ferrajoli, MD

Associate Medical Director, Professor

Department of Leukemia Center

The University of Texas MD Anderson Cancer Center

Houston

TX

Declarações

AF declares that she has no competing interests.

Farrukh Awan, MD

​Professor of Medicine

Department of Internal Medicine

UT Southwestern Medical Center

Dallas

TX

Declarações

FA declares that he has no competing interests.

Paolo F. Caimi, MD

Associate Professor

Department of Medicine

Case Western Reserve University

Case Comprehensive Cancer Center

Cleveland

OH

Declarações

PFC has received honoraria from Celgene for participation in a speaker bureau, and from Kite Pharma for participation in an advisory board.

Daniel Catovsky, MD, FRCP, FRCPath, DSc, FMedSc

Consultant Haemato-oncologist

Section of Haemato-Oncology

The Institute of Cancer Research

Sutton

UK

Declarações

Unfortunately, we have since been made aware that DC is deceased.

  • Diagnósticos diferenciais

    • Fase leucêmica do linfoma
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Chronic lymphocytic leukemia/small lymphocytic lymphoma
    • Hematopoietic cell transplantation (HCT)
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Leukaemia (chronic lymphocytic)

    Mais Folhetos informativos para os pacientes
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