Mature B-cell leukemias

Constantine S. Tam, Michael J. Keating

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Researchpeer-review

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Abstract

Introduction The mature B-cell leukemias are a pathologically diverse group of diseases that share commonalities in clinical presentation and behavior. Early stage patients are often diagnosed incidentally on a routine complete blood count and blood film, whereas advanced stage patients present with lymphadenopathy, organomegaly, bone marrow infiltration and cytopenias. All of these leukemias are considered “indolent” in that they tend to progress relatively slowly (over months to years), and all are currently incurable with conventional therapy but are often exquisitely sensitive to the graft-versus-leukemia effect of allogeneic stem cell transplantation. Precise classification of mature B-cell leukemias is important as each entity confers a different prognosis and requires individual treatment approaches. Most mature B-cell lymphomas can be defined using morphological and immunophenotypic markers. More recently, with the discovery of recurrent cytogenetic and molecular genetic rearrangements in individual leukemia subtypes, it has become possible to fine-tune the classification of mature B-cell leukemias using genetic features. The majority of this chapter will be devoted to the discussion of chronic lymphocytic leukemia (CLL), the most common mature B-cell leukemia (Figure 9.1), which serves as the prototypical disease in this category. Chronic lymphocytic leukemia Clinical example A 56-year-old man presented for a routine physical examination. A full blood examination was requested and showed a lymphocytosis of 18 × 109/L. A repeat test four weeks later showed the lymphocytosis to persist. How should this patient be evaluated?

Original languageEnglish
Title of host publicationDiagnostic Techniques in Hematological Malignancies
EditorsWendy N. Erber
PublisherCambridge University Press
Chapter9
Pages171-190
Number of pages20
ISBN (Electronic)9780511760273
ISBN (Print)9780521111218
DOIs
Publication statusPublished - Dec 2010
Externally publishedYes

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