CAUSES AND CLINICAL PICTURE OF Chronic Lymphatic leukaemia

•          Chronic Lymphatic leukaemia
Def: characterized by an uncontrolled proliferation and accumulation of lymphocytes that are mostly mature but immunologically incomptent.

•          It is characterized by peripheral blood lymphocytosis and a variable degree of infiltration of the BM, LNs, spleen and liver

•          Incidence increases with age. Median age : 65 years.

•           Incidence : 2.5: 100,000

•          Clinical Features of CLL
The disease of old age often asymptomatic & deteced accidentally

•          May complain from recurrent infection, wt loss, manifestations of BM infiltration: anaemia, neutropenia, thrombocytopenia

•          G. lymphadenopathy , moderate splenomegaly, hepatomegaly

•          AIHA , AI thrombocytopenia may occur

•          Investigations for CLL  
FBC and blood film: lymphocytosis > 5X 10⁹/L. They are mature

•          Anaemia, neutropenia, thrombocytopenia due to BM failure are usually absent in early stage however they can be caused by Autoimmune mechanisms

•          BM: Lymphocytosis > 25% with characteristic immunophenotyic markers

•          Treatment of CLL
The disease may remain stable for years, most patients die of unrelated causes

•          Indications to start treatment: 1- Anaemia            2- Recurrent infection  3- Bleeding                        4- Bulky disfiguring or compressing LNs                5- Increasing splenomegaly

•          Treatment : Chlorambucil with or without Prednisolone , prednisolone to control AIHA , sometimes radiation to relieve a compression