Thursday, March 11, 2010

B-cell chronic lymphocytic leukemia

B-cell chronic lymphocytic leukemia - Chronic
Rahul Soman, M. Pharm


 

Definition  

Proliferation and progressive accumulation of morphologically mature but immunologically less mature monoclonal B-cells in the blood, bone marrow, and lymphoid tissues


 

Medical History  

* White

* Male

* Middle-aged or Older

* Family history of Lymphoid leukemia

* Russian or Eastern European Jew


 

Findings  

* Asymptomatic

* Lymphadenopathy

* Hepatosplenomegaly

* Asthenia

* Fatigue

* Fever

* Night sweats

* Weight loss

* Increased susceptibility to infections

* Blood coagulation disorder

* Insect bite reaction

* Easy bruising


 

Tests  


 

Suspected chronic lymphocytic leukemia  

* Complete blood count with white cell differential, manual: Lymphocyte count ranges from 5 to 500 x 109/L in CLL; neutrophil proportion, hemoglobin, and platelets are decreased .


 

Initial evaluation of suspected chronic lymphocytic leukemia  

* Lymphocyte count by cell surface antigen phenotype


 

Initial evaluation of suspected chronic lymphocytic leukemia  

* Lymphocyte surface immunoglobulin identification


 

Suspected and known chronic lymphocytic leukemia  

* Bone marrow examination: Bone marrow lymphocyte count may range from 30% up to 99% of all nucleated cells; a diffuse pattern of lymphocytic infiltration has a poor prognosis .


 

Initial evaluation of suspected and known chronic lymphocytic leukemia  

* Serum protein electrophoresis

* Immunoglobulin measurement

* Coombs test - anti-human globulin


 

Initial evaluation of chronic lymphocytic leukemia and treatment planning  

* Hepatic function panel

* Biochemical evaluation of blood urea/renal function

* Electrolytes measurement, serum


 

Differential Diagnosis  

* Hairy cell leukemia

* Waldenström macroglobulinemia

* Prolymphocytic leukemia

* Large granular lymphocytic leukemia

* Mantle cell lymphoma

* Smoldering chronic lymphocytic leukemia


 

Treatment  


 

Procedural Therapy  


 

Chronic lymphocytic leukemia  

* Hemopoietic stem cell transplant: Stem cell transplantation increases disease-free survival and may increase overall survival in poor-risk CLL patients .

No comments:

Post a Comment

SYSTEM BASED CLASSIFICATION OF DISEASES

SYSTEM BASED CLASSIFICATION OF DISEASES

Bone and Joint Diseases

  1. Gout and Hyperurecemia
  2. Osteoarthritis
  3. Rheumatoid Arthritis
  4. Acute coronary Syndroms

Cardiovascular Diseases

  1. Arrhymias
  2. Cardiopulmanary Resuscitation
  3. Heart Failure
  4. Hypertension
  5. Hyperlipidemia
  6. Ischemic Heart Diseases
  7. Shock
  8. Stroke
  9. Venous Thromboembolism

Dermatrologic Diseases

  1. Acne
  2. Psoriasis
  3. Skin Disorders and Cutaneous Drug Eruptions

Endocrine Diseases

  1. Cirrhosis
  2. Portal Hypertension

Gastrointestinal Diseases

  1. Irritable Bowel Syndrome
  2. Constipation
  3. Diarrhea
  4. Gastroesophagal Reflux Disease
  5. Hepatitis, Viral
    1. Hepatitis A
    2. Hepatitis B
    3. Hepatitis C
  6. Nausea and Vomiting
  7. Pancreatitis
  8. Peptic Ulcer disease

Gynecologic and Obstetric Diseases

  1. Contraception
  2. Hormone therapy

Hematologic Diseases

  1. Anemia
    1. Megaloblastic Anemia

i. Megaloblastic Anemia due to Folate Deficiency

ii. Megaloblastic Anemia due to Vitamine B12 Deficiency

    1. Sickle Cell anemia
    2. Hemolytic Anemia
    3. Iron Deficiency Anemia
    4. Aplastic Anemia
    5. Iron Deficiency Anemia

Infectious Diseases

  1. Central Nervous System infections
  2. Endocarditis
  3. Fungal infections, Invasive
  4. Gastrointestinal Infection
  5. HIV / AIDS
  6. Intra-Abdominal Infection
  7. Respiratory Tract infections, Lower
  8. Respiratory Tract infections, Upper
  9. Sepsis and Septic Shock
  10. Sexually transmited Diseases (STD)
  11. Skin and soft tissue infection
  12. Tuberculosis
  13. Urinary tract infection and prostatitis

Neurologic Diseases

  1. Epilepsy
  2. Headache
    1. Migraine
    2. Cluster Headache
  3. Pain management
  4. Parkinson’s Diseases
  5. Status epilepticus

Nutritional Diseases

  1. Enteral Nutrition
  2. Obesity
  3. Parentaral Nutrition

Onchologic Diseases

  1. Breast cancer
  2. Colorectal Cancer
  3. Lung cancer
  4. Lymphomas
  5. Prostate cancer
  6. Cervical Cancer
  7. Esophageal Cancer
  8. Gastric Cancer
  9. Head and Neck Cancer
  10. Lung Cancer
  11. Ovarian Cancer
  12. Pancreatic Cancer
  13. Primary bone Cancer
  14. Primary Brain cancer
  15. Testicular Cancer
  16. Thyroid Gland Cancer
  17. Urinar Bladder cancer
  18. Uterine Cancer

Ophtalmic Diseases

  1. Glaucoma

Psychiatric Diseases

  1. Alzhimer’s Diseases
  2. Anxiety Disease
  3. Bipolar Diseases
  4. Depressive diseases
  5. Schizophrenia
  6. Sleep Diseases
  7. Substance-Related Diseases

Renal Diseases

  1. Acid base Diseases
  2. Acute renal Failure
  3. Chronic Renal Failure
  4. Drug Dosing in renal insufficiency
  5. Electrolyte Homeostasis

Respiratory Diseases

  1. Allergic Rhinitis
  2. Asthma
  3. Chronic Obstructive Pulmonary Diseases

Urologic Diseases

  1. Benign Prostatic, Hyperplasia
  2. Erectile Dysfunction
  3. Urinary Incontinence