Chronic lymphocytic leukaemia
Last updated: Tuesday, 23, November, 2010
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.|
|See Humoral immune deficiency under Infection (increased susceptibility).|
|See Cell mediated (T cell) immune dysfunction under Infection (increased susceptibility).|
|Direct antiglobulin test, platetelet antibodies, neutrophil antibodies as appropriate.|