Chronic lymphocytic leukaemia

Last updated: Tuesday, 23, November, 2010
ConsequencesAppropriate Tests

FBC (lymphocytosis with smudge cells ± anaemia ± neutropenia ± thrombocytopenia); immunophenotyping (blood or bone marrow).

Bone marrow aspiration and trephine biopsy are often not required if a clearcut diagnosis is available on immunophenotyping.

Immunoglobulins G, A, M; protein electrophoresis - serum with IFE to detect a paraprotein.

See Table 2 Reference intervals for immunoglobulins G, A, M (g/L)

Cytogenetics (oncology) not required for diagnosis, but may provide information on prognosis.

Immunoglobin heavy chain mutation status or Zap-70 assessment have been shown to correlate with clinical outcome; Beta2 microblobulin in serum.

Lymph node biopsy is rarely indicated.

See Table 1: summary of antigen expression in chronic lymphoproliferative disorders.

See also Lymphoproliferative disorders and Chronic leukaemia

Immunodeficiency, due to:

Recurrent infection is a common clinical problem.
  • Hypogammaglobulinaemia
See Humoral immune deficiency under Infection (increased susceptibility).

  • T cell functional defect

See Cell mediated (T cell) immune dysfunction under Infection (increased susceptibility).
  • Autoimmune
Direct antiglobulin test, platetelet antibodies, neutrophil antibodies as appropriate.
  • Bone marrow infiltration
  • Cytotoxic drug ± Antic D20 therapy
  • Hypersplenism