Chronic lymphocytic leukemia natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Overview

Most patients with chronic lymphocytic leukemia are initially asymptomatic. If left untreated, patients with chronic lymphocytic leukemia may progress to develop weight loss, fever, and lymph nodes swelling. Common complications of chronic lymphocytic leukemia include immunodeficiency, warm autoimmune hemolytic anemia, and Richter's transformation. Prognosis is generally good, and the 5-year survival rate of patients with chronic lymphocytic leukemia is 81.7%.

Natural History, Complications and Prognosis

Natural History

Complications

  • Common complications of chronic lymphocytic leukemia include:[1][2][3][4]

Prognosis

Prognostic Factor Description
Age
Gender
Performance status
Stage
  • Binet stages B and C or Rai stages 2-4 are associated with a worse prognosis.
Lymphocyte doubling time
Genetic mutations
Prolymphocytes percent
  • An increased percentage of prolymphocytes is associated with a worse prongnosis.
Histological analysis
Lactate dehydrogenase (LDH) level
β2-microglobulin level
  • Elevated level of β2-microglobulin is associated with a worse prognosis.
Lymphocyte surface markers
Immunoglobulin (Ig)VH gene
Membrane-bound proteins

References

  1. 1.0 1.1 Nabhan C, Rosen ST (2014). "Chronic lymphocytic leukemia: a clinical review". JAMA. 312 (21): 2265–76. doi:10.1001/jama.2014.14553. PMID 25461996.
  2. Mauro FR, Foa R, Cerretti R, Giannarelli D, Coluzzi S, Mandelli F, Girelli G (May 2000). "Autoimmune hemolytic anemia in chronic lymphocytic leukemia: clinical, therapeutic, and prognostic features". Blood. 95 (9): 2786–92. PMID 10779422.
  3. Robertson LE, Pugh W, O'Brien S, Kantarjian H, Hirsch-Ginsberg C, Cork A, McLaughlin P, Cabanillas F, Keating MJ (October 1993). "Richter's syndrome: a report on 39 patients". J. Clin. Oncol. 11 (10): 1985–9. doi:10.1200/JCO.1993.11.10.1985. PMID 8410123.
  4. Visco C, Ruggeri M, Laura Evangelista M, Stasi R, Zanotti R, Giaretta I, Ambrosetti A, Madeo D, Pizzolo G, Rodeghiero F (February 2008). "Impact of immune thrombocytopenia on the clinical course of chronic lymphocytic leukemia". Blood. 111 (3): 1110–6. doi:10.1182/blood-2007-09-111492. PMID 17986663.
  5. SEER Stat Fact Sheets: Chronic Lymphocytic Leukemia. National Cancer Institute (2015) http://seer.cancer.gov/statfacts/html/clyl.html Accessed on October, 12 2015
  6. Chen C, Puvvada S (February 2016). "Prognostic Factors for Chronic Lymphocytic Leukemia". Curr Hematol Malig Rep. 11 (1): 37–42. doi:10.1007/s11899-015-0294-x. PMID 26748932.
  7. Shanafelt TD, Geyer SM, Kay NE (February 2004). "Prognosis at diagnosis: integrating molecular biologic insights into clinical practice for patients with CLL". Blood. 103 (4): 1202–10. doi:10.1182/blood-2003-07-2281. PMID 14576043.
  8. Chen C, Puvvada S (February 2016). "Prognostic Factors for Chronic Lymphocytic Leukemia". Curr Hematol Malig Rep. 11 (1): 37–42. doi:10.1007/s11899-015-0294-x. PMID 26748932.




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