Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- dispneia e fadiga
- linfadenopatia
- esplenomegalia
- hepatomegalia
Outros fatores diagnósticos
- presença de fatores de risco
- sintomas B
- infecções recorrentes
- petéquias
Fatores de risco
- idade superior a 60 anos
- sexo masculino
- etnia branca
- história familiar de leucemia linfoide crônica (LLC)
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- contagem diferencial de leucócitos
- esfregaço
- hemoglobina
- contagem plaquetária
- citometria de fluxo
Investigações a serem consideradas
- hibridização in situ fluorescente (FISH)
- biópsia de linfonodos
- análise genética molecular
- teste de antiglobulina direto (TAD)
- níveis de imunoglobulina
- aspirado de medula óssea e biópsia por trefina
- TC/PET com fluordesoxiglucose (FDG)-CT
Algoritmo de tratamento
fase inicial assintomática (Binet A e B; Rai 0-II)
doença avançada (Binet C; Rai III-IV) ou sintomática
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
Daniel Catovsky, MD, FRCP, FRCPath, DSc, FMedSc
Consultant Haemato-oncologist
Section of Haemato-Oncology
The Institute of Cancer Research
Sutton
UK
Declarações
DC 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.
Diagnósticos diferenciais
- Fase leucêmica do linfoma
Mais Diagnósticos diferenciaisDiretrizes
- Chronic lymphocytic leukemia/small lymphocytic lymphoma
- Hematopoietic cell transplantation (HCT)
Mais DiretrizesFolhetos informativos para os pacientes
Leucemia (linfocítica crônica)
Mais Folhetos informativos para os pacientes- Conectar-se ou assinar para acessar todo o BMJ Best Practice
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