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Chronic lymphocytic leukemia is diagnosed according to the International Workshop on Chronic Lymphocytic Leukemia (iwCLL) guidelines:<ref name="pmid29540348">{{cite journal |vauthors=Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, Hillmen P, Keating M, Montserrat E, Chiorazzi N, Stilgenbauer S, Rai KR, Byrd JC, Eichhorst B, O'Brien S, Robak T, Seymour JF, Kipps TJ |title=iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL |journal=Blood |volume=131 |issue=25 |pages=2745–2760 |date=June 2018 |pmid=29540348 |doi=10.1182/blood-2017-09-806398 |url=}}</ref><ref name="pmid3189311">{{cite journal |vauthors=Cheson BD, Bennett JM, Rai KR, Grever MR, Kay NE, Schiffer CA, Oken MM, Keating MJ, Boldt DH, Kempin SJ |title=Guidelines for clinical protocols for chronic lymphocytic leukemia: recommendations of the National Cancer Institute-sponsored working group |journal=Am. J. Hematol. |volume=29 |issue=3 |pages=152–63 |date=November 1988 |pmid=3189311 |doi= |url=}}</ref> | Chronic lymphocytic leukemia is diagnosed according to the International Workshop on Chronic Lymphocytic Leukemia (iwCLL) guidelines:<ref name="pmid29540348">{{cite journal |vauthors=Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, Hillmen P, Keating M, Montserrat E, Chiorazzi N, Stilgenbauer S, Rai KR, Byrd JC, Eichhorst B, O'Brien S, Robak T, Seymour JF, Kipps TJ |title=iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL |journal=Blood |volume=131 |issue=25 |pages=2745–2760 |date=June 2018 |pmid=29540348 |doi=10.1182/blood-2017-09-806398 |url=}}</ref><ref name="pmid3189311">{{cite journal |vauthors=Cheson BD, Bennett JM, Rai KR, Grever MR, Kay NE, Schiffer CA, Oken MM, Keating MJ, Boldt DH, Kempin SJ |title=Guidelines for clinical protocols for chronic lymphocytic leukemia: recommendations of the National Cancer Institute-sponsored working group |journal=Am. J. Hematol. |volume=29 |issue=3 |pages=152–63 |date=November 1988 |pmid=3189311 |doi= |url=}}</ref> | ||
* Complete blood count (CBC) with differential: Absolute lymphocytosis ≥5000 B-lymphocytes/µL X ≥ 3 months | * Complete blood count (CBC) with differential: Absolute lymphocytosis ≥5000 B-lymphocytes/µL X ≥ 3 months | ||
* Flow cytometry: B lymphocytes clonality (Immunoglobulin light chain restriction) | * Flow cytometry: B lymphocytes clonality (Immunoglobulin light chain restriction)<ref name="pmid29024461">{{cite journal |vauthors=Rawstron AC, Kreuzer KA, Soosapilla A, Spacek M, Stehlikova O, Gambell P, McIver-Brown N, Villamor N, Psarra K, Arroz M, Milani R, de la Serna J, Cedena MT, Jaksic O, Nomdedeu J, Moreno C, Rigolin GM, Cuneo A, Johansen P, Johnsen HE, Rosenquist R, Niemann CU, Kern W, Westerman D, Trneny M, Mulligan S, Doubek M, Pospisilova S, Hillmen P, Oscier D, Hallek M, Ghia P, Montserrat E |title=Reproducible diagnosis of chronic lymphocytic leukemia by flow cytometry: An European Research Initiative on CLL (ERIC) & European Society for Clinical Cell Analysis (ESCCA) Harmonisation project |journal=Cytometry B Clin Cytom |volume=94 |issue=1 |pages=121–128 |date=January 2018 |pmid=29024461 |pmc=5817234 |doi=10.1002/cyto.b.21595 |url=}}</ref> | ||
Presence of clonal B-lymphocutosis <5000/µL without cytpenia, hepatosplenomegaly, lymphadenopathy or other disease-related symptoms can be defined as monoclonal B lymphocytosis (MBL). MBL will progress to CLL at a rate of 1% to 2% per year.<ref name="pmid18687638">{{cite journal |vauthors=Rawstron AC, Bennett FL, O'Connor SJ, Kwok M, Fenton JA, Plummer M, de Tute R, Owen RG, Richards SJ, Jack AS, Hillmen P |title=Monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia |journal=N. Engl. J. Med. |volume=359 |issue=6 |pages=575–83 |date=August 2008 |pmid=18687638 |doi=10.1056/NEJMoa075290 |url=}}</ref> | Presence of clonal B-lymphocutosis <5000/µL without cytpenia, hepatosplenomegaly, lymphadenopathy or other disease-related symptoms can be defined as monoclonal B lymphocytosis (MBL). MBL will progress to CLL at a rate of 1% to 2% per year.<ref name="pmid18687638">{{cite journal |vauthors=Rawstron AC, Bennett FL, O'Connor SJ, Kwok M, Fenton JA, Plummer M, de Tute R, Owen RG, Richards SJ, Jack AS, Hillmen P |title=Monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia |journal=N. Engl. J. Med. |volume=359 |issue=6 |pages=575–83 |date=August 2008 |pmid=18687638 |doi=10.1056/NEJMoa075290 |url=}}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]
Overview
The diagnostic study of choice in chronic lymphocytic leukemia is according to the International Workshop on Chronic Lymphocytic Leukemia (iwCLL) guidelines which involves complete blood count (CBC) with differential and peripheral smear flow cytometry.
Diagnostic study of choice
The diagnostic study of choice in chronic lymphocytic leukemia is peripheral blood flow cytometry. If peripheral blood flow cytometry shows greater than 5000 clonal B cell per microliter, the diagnosis is confirmed. Ancillary tests include bone marrow biopsy and peripheral blood cytogenetics or FISH studies.
Chronic lymphocytic leukemia is diagnosed according to the International Workshop on Chronic Lymphocytic Leukemia (iwCLL) guidelines:[1][2]
- Complete blood count (CBC) with differential: Absolute lymphocytosis ≥5000 B-lymphocytes/µL X ≥ 3 months
- Flow cytometry: B lymphocytes clonality (Immunoglobulin light chain restriction)[3]
Presence of clonal B-lymphocutosis <5000/µL without cytpenia, hepatosplenomegaly, lymphadenopathy or other disease-related symptoms can be defined as monoclonal B lymphocytosis (MBL). MBL will progress to CLL at a rate of 1% to 2% per year.[4]
References
- ↑ Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, Hillmen P, Keating M, Montserrat E, Chiorazzi N, Stilgenbauer S, Rai KR, Byrd JC, Eichhorst B, O'Brien S, Robak T, Seymour JF, Kipps TJ (June 2018). "iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL". Blood. 131 (25): 2745–2760. doi:10.1182/blood-2017-09-806398. PMID 29540348.
- ↑ Cheson BD, Bennett JM, Rai KR, Grever MR, Kay NE, Schiffer CA, Oken MM, Keating MJ, Boldt DH, Kempin SJ (November 1988). "Guidelines for clinical protocols for chronic lymphocytic leukemia: recommendations of the National Cancer Institute-sponsored working group". Am. J. Hematol. 29 (3): 152–63. PMID 3189311.
- ↑ Rawstron AC, Kreuzer KA, Soosapilla A, Spacek M, Stehlikova O, Gambell P, McIver-Brown N, Villamor N, Psarra K, Arroz M, Milani R, de la Serna J, Cedena MT, Jaksic O, Nomdedeu J, Moreno C, Rigolin GM, Cuneo A, Johansen P, Johnsen HE, Rosenquist R, Niemann CU, Kern W, Westerman D, Trneny M, Mulligan S, Doubek M, Pospisilova S, Hillmen P, Oscier D, Hallek M, Ghia P, Montserrat E (January 2018). "Reproducible diagnosis of chronic lymphocytic leukemia by flow cytometry: An European Research Initiative on CLL (ERIC) & European Society for Clinical Cell Analysis (ESCCA) Harmonisation project". Cytometry B Clin Cytom. 94 (1): 121–128. doi:10.1002/cyto.b.21595. PMC 5817234. PMID 29024461.
- ↑ Rawstron AC, Bennett FL, O'Connor SJ, Kwok M, Fenton JA, Plummer M, de Tute R, Owen RG, Richards SJ, Jack AS, Hillmen P (August 2008). "Monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia". N. Engl. J. Med. 359 (6): 575–83. doi:10.1056/NEJMoa075290. PMID 18687638.