Chronic lymphocytic leukemia diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]

Overview

The diagnostic study of choice in chronic lymphocytic leukemia is according to the International Workshop on Chronic Lymphocytic Leukemia (iWCLL) guidelines, which involves complete blood count (CBC) with differential and peripheral smear flow cytometry.

Diagnostic study of choice

  • Chronic lymphocytic leukemia is diagnosed according to the International Workshop on Chronic Lymphocytic Leukemia (iwCLL) guidelines:[1][2][3][4][5]
    • Complete blood count (CBC) with differential: Absolute lymphocytosis ≥5000 B-lymphocytes/µL X ≥ 3 months
    • Flow cytometry: B lymphocytes clonality (Immunoglobulin light chain restriction)[6]
  • Presence of clonal B-lymphocytosis <5000/µL without cytopenia, hepatosplenomegaly, lymphadenopathy or other disease-related symptoms can be defined as monoclonal B lymphocytosis (MBL). MBL will progress to CLL at a rate of 1% to 2% per year.[7]

References

  1. Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, Hillmen P, Keating M, Montserrat E, Chiorazzi N, Stilgenbauer S, Rai KR, Byrd JC, Eichhorst B, O'Brien S, Robak T, Seymour JF, Kipps TJ (June 2018). "iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL". Blood. 131 (25): 2745–2760. doi:10.1182/blood-2017-09-806398. PMID 29540348.
  2. Cheson BD, Bennett JM, Rai KR, Grever MR, Kay NE, Schiffer CA, Oken MM, Keating MJ, Boldt DH, Kempin SJ (November 1988). "Guidelines for clinical protocols for chronic lymphocytic leukemia: recommendations of the *National Cancer Institute-sponsored working group". Am. J. Hematol. 29 (3): 152–63. PMID 3189311.
  3. Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, Hillmen P, Keating MJ, Montserrat E, Rai KR, Kipps TJ (June 2008). "Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer *Institute-Working Group 1996 guidelines". Blood. 111 (12): 5446–56. doi:10.1182/blood-2007-06-093906. PMC 2972576. PMID 18216293.
  4. Hallek M (May 2015). "Chronic lymphocytic leukemia: 2015 Update on diagnosis, risk stratification, and treatment". Am. J. Hematol. 90 (5): 446–60. doi:10.1002/ajh.23979. PMID 25908509.
  5. Cheson BD, Bennett JM, Grever M, Kay N, Keating MJ, O'Brien S, Rai KR (June 1996). "National Cancer Institute-sponsored Working Group guidelines for chronic lymphocytic leukemia: revised guidelines for diagnosis and treatment". Blood. 87 (12): 4990–7. PMID 8652811.
  6. Rawstron AC, Kreuzer KA, Soosapilla A, Spacek M, Stehlikova O, Gambell P, McIver-Brown N, Villamor N, Psarra K, Arroz M, Milani R, de la Serna J, Cedena MT, Jaksic O, Nomdedeu J, Moreno C, Rigolin GM, Cuneo A, Johansen P, Johnsen HE, Rosenquist R, Niemann CU, Kern W, Westerman D, Trneny M, Mulligan S, Doubek M, Pospisilova S, Hillmen P, Oscier D, Hallek M, Ghia P, Montserrat E (January 2018). "Reproducible diagnosis of chronic lymphocytic leukemia by flow cytometry: An European Research Initiative on CLL (ERIC) & European Society for Clinical Cell Analysis (ESCCA) Harmonisation project". Cytometry B Clin Cytom. 94 (1): 121–128. doi:10.1002/cyto.b.21595. PMC 5817234. PMID 29024461.
  7. Rawstron AC, Bennett FL, O'Connor SJ, Kwok M, Fenton JA, Plummer M, de Tute R, Owen RG, Richards SJ, Jack AS, Hillmen P (August 2008). "Monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia". N. Engl. J. Med. 359 (6): 575–83. doi:10.1056/NEJMoa075290. PMID 18687638.