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]; Raviteja Guddeti, M.B.B.S. [3]

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 node 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 approximately 81.7%.

Natural History, Complications and Prognosis

Natural History

• 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 node swelling.

Complications

• Common complications of chronic lymphocytic leukemia include:

• Richter's transformation
• Immunodeficiency
• Warm autoimmune hemolytic anemia
• Autoimmune thrombocytopenia
• Intussusception
• Small intestinal bacterial contamination
• Colitis

Prognosis

• Prognosis is generally good, and the 5-year survival rate of patients with chronic lymphocytic leukemia is approximately 81.7%.
• Common prognostic factors for meningioma chronic lymphocytic leukemia patients age, tumor stage, and the presence of certain genetic mutations.
• The table below lists prognostic factors for chronic lymphocytic leukemia:

Prognostic Factor	Description
Age	Older age of diagnosis is associated with a worse prognosis.
Gender	Males are associated with a worse prognosis.
Performance status	Patient's poor performance status is associated with a worse prognosis.
Stage	Binet stages B and C or Rai stages II–IV are associated with a worse prognosis.
Lymphocyte doubling time	A rapid lymphocyte doubling time is associated with a worse prognosis
Genetic mutations	Deletion of chromosome 17 short arm and chromosome 11 long arm are associated with a worse prognosis.
Prolymphocytes percent	An increased percentage of prolymphocytes is associated with a worse prongnosis.
Histological analysis	Diffuse histology on bone marrow aspiration is associated with a worse prognosis.
Lactate dehydrogenase (LDH) level	Elevated levels of LDH are associated with a worse prognosis.
β2-microglobulin level	Elevated levels of β2-microglobulin level are associated with a worse prognosis.
Lymphocyte surface marker	Over expression of CD38 is associated with a worse prognosis.
Immunoglobulin (Ig)VH gene	The absence of IgVH gene mutation is associated with a worse prognosis.
Membrane-bound proteins	The expression of Zeta-chain-associated protein kinase 70 (ZAP) is associated with a poor prognosis.

References

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