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 language | English |
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Title of host publication | Diagnostic Techniques in Hematological Malignancies |
Editors | Wendy N. Erber |
Publisher | Cambridge University Press |
Chapter | 9 |
Pages | 171-190 |
Number of pages | 20 |
ISBN (Electronic) | 9780511760273 |
ISBN (Print) | 9780521111218 |
DOIs | |
Publication status | Published - Dec 2010 |
Externally published | Yes |