| Description |
Chronic lymphocytic leukemia/Small lymphocytic leukemia. Patients
have constitutional symptoms, LAD, HSM, and in about 15% of cases, patients
have RBC autoantibodies and develop an autoimmune hemolytic anemia .
Median survival is 4-6 years. May undergo transformation to prolymphocytic
lymphoma or diffuse large B-cell lymphoma. Morphologically, there
is loss of nodal architecture. The field is full of small lymphocytes
and may have prolymphocytes, larger cells with may form proliferation centers.
Smudge cells are common on peripheral smear. To make the diagnosis,
more than 30% of the marrow must be replaced. There should be less
than 10% peripherally circulating prolymphocytes to distinguish it from
prolymphocytic leukemia. |
| Frequency |
This is the most common leukemia in adults. About 2:1 male to
female predominance, more common over age 50. |
| Cytogenetics |
| Locus |
Product |
Description |
| t(14;18) |
IgH-bcl-2 fusion |
Like follicular center lymphomas,
this lymphoma may express the anti-apoptotic protein bcl-2. |
| chromosome 3 |
bcl-6
Zinc-finger protein |
Associated with immune deficiency states and infection with eithe EBV
or human herpes virus 6. |
|
| Markers |
| Positive |
CD5 (unlike most B cells), IgM (faint), CD19, CD20, CD79a, CD23, CD43 |
| +/- |
|
| Negative |
CD10 |
|
