lab report of chronic lymphocytic leukemia patient

Common tests & procedures

What is the outlook for chronic lymphocytic leukemia?

• CLL overview. CLL does not usually present symptoms, and older adults are more likely to be affected by it. ...
• Survival rates. Survival rates can give a person more information about the outlook for their illness and help them to plan treatment and care.
• Factors that influence life expectancy. ...
• Living with CLL. ...
• Takeaway. ...

What is the life expectancy for chronic lymphocytic leukemia?

There are three phases of CML:

• Chronic phase: During the first phase, the cancer cells are growing slowly. ...
• Accelerated phase: The leukemia cells grow and develop more quickly in the second phase.
• Blastic phase: In the third phase, the abnormal cells have grown out of control and are crowding out normal, healthy cells.

What is the life expectancy for someone with CMML?

If you have to choose one type of leukemia, it should be chronic lymphocytic leukemia and here are the reasons: Chronic lymphocytic leukemia mostly affects people above 50 or even 60 years old, and the mean 5-year survival is 83% with some patients living up to 2 decades with this type of leukemia.

How long can you live with chronic lymphocytic leukemia?

The underlying cause of chronic lymphocytic leukemia (CLL) is not known. About 10% of people with CLL have a family history of this condition. [1] Other risk factors include age, exposure to pesticides or herbicides, allergic conditions, and a current hepatitis C infections. [1]

Do we know what causes chronic lymphocytic leukemia?

What is the ALC of CLL?

The diagnosis of CLL is dependent on finding on a complete blood count (CBC) an absolute lymphocyte count (ALC) of more than 5,000 or 5,000/microL [5 x 109/L] lymphocytes, specifically more than 5000 clonal B-lymphocytes, present for at least three months.

What is CLL in hematology?

Hematology in general and CLL specifically are full of jargon and acronyms that can be both overwhelming and daunting . With time and experience, you’ll become familiar with the terminology and acronyms. We will try to explain each medical term the first time it appears in an article, but we will use the true terminology so that you gain comfort and familiarity with the medical terms that you will see in your lab reports and in medical articles. We have provided a list of abbreviations and acronyms as well as a glossary for your reference.

How many B cells are needed for a CLL clone?

So in summary, it is not enough to just have a high white blood count or a high percentage of lymphocytes or even an ALC of over 5,000, but we must have more than 5,000 clonal B cells to make the diagnosis. The truth is that when the ALC is significantly high, say 20,000 or higher, odds are very good that the vast majority of the cells are from the CLL clone.

Why are lymphocytes called lymphocytes?

They are called lymphocyte because they are the cells found in lymph nodes. There are three basic types of lymphocytes. NK or natural killers and T cells are different parts of our cell mediated or cellular immune response to infections and cancers.

How long does it take for a B lymphocyte to be clonal?

To diagnose chronic lymphocytic leukemia (CLL), there needs to be ≥5000 monoclonal (genetically identical) B-lymphocytes (a type of white blood cell) in the blood for the duration of at least three months. The clonal nature of the circulating B-lymphocytes should be confirmed by flow cytometry ...

What percentage of WBC is lymphocytes?

In this sample result one can easily calculate that the 80% of the total WBC of 20,000 are lymphocytes resulting in an absolute lymphocyte count (lymph# or ALC) of 16,000 most consistent with a diagnosis of CLL.

Is SLL a lymphoma?

The diagnosis of SLL should be confirmed by lymph node biopsy. CLL/SLL is considered both a lymphoma and leukemia.

What is chronic lymphocytic leukemia?

Chronic lymphocytic leukemia is a chronic lymphoproliferative disorder characterized by monoclonal B cell proliferation. It is the most common adult leukemia in Western populations and comprises 25 to 30 percent of leukemias in the United States. This activity reviews the evaluation and management of chronic lymphocytic leukemia and highlights the role of interprofessional team members in collaborating to provide well-coordinated care and enhance outcomes for affected patients.

What is the diagnosis of CLL?

If the biopsy specimen demonstrates greater than 30% lymphocytes of all nucleated cells in a normocellular/hypercellular bone marrow aspirate, this confirms the diagnosis of CLL. The reduction of lymphocytic infiltration to less than 30% on treatment indicates a complete response. Furthermore, three infiltrative patterns of lymphocytes have been recognized in the bone marrow biopsy specimens: nodular, interstitial, and diffuse.  A biopsy sample can demonstrate a mixture of nodular and interstitial, or nodular and diffuse patterns. Studies have shown that patients with a diffuse pattern on biopsy tend to have advanced disease with poor prognosis, whereas nodular and interstitial patterns ("non-diffuse" category) have a better prognosis. [52][53][54]

What is CLL in a cell?

Chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) is an indolent malignancy characterized by increased production of mature but dysfunctional B lymphocytes. CLL/SLL is defined as a monoclonal lymphoproliferative disease characterized by the proliferation and accumulation of morphologically mature but immunologically dysfunctional B-cell lymphocytes that are smudge cells, as noted on peripheral smear. The primary disease sites include peripheral blood, spleen, lymph nodes, and bone marrow.  CLL and SLL are identical from a pathologic and immunophenotypic standpoint. Both CLL and SLL originate from B-cell lymphocytes but present with different manifestations depending on where the abnormal cells are found.   Usually, the initial leukemic phase represents CLL, where the cells are present in the blood.   This eventually progresses to the lymphoma phase, representing SLL, where the cells are found in the lymph nodes. The term SLL is commonly used to represent the lymphoproliferative process limited to the lymph nodes.

How long does it take for lymphocytosis to increase?

Progressive lymphocytosis with >50% increase in lymphocytes over a 2-month period or lymphocyte doubling time (LDT) of <6 months. LDT is obtained by linear regression extrapolation of absolute lymphocyte counts at every 2 weeks interval period over a time span of 2 to 3 months. Patients with initial blood lymphocyte counts of <30,000/mcL may need to be observed for a longer time period to help determine the LDT. Also, other lymphocytosis/lymphadenopathy contributing factors (e.g., infection) other than CLL should be excluded.

How many people will die from CLL in 2020?

According to the American Cancer Society, there will be approximately 21,040 new CLL cases and about 4,060 deaths in the year of 2020. Worldwide, 191,000 cases and 61,000 deaths are attributed to CLL/SLL every year. CLL can affect adults as young as 30 years of age. However, it is mostly seen in adults with an average age of 70 years. CLL is extremely rare in children. The incidence is known to rapidly increase with increasing age. CLL has a slightly higher incidence in male populations than female populations (1.3 to 1 to 1.7 to 1). However, studies have shown that women can have a more aggressive form of the disease than men. [11][12][13]

What are the causes of CLL?

The exact etiology of CLL is unknown. Genetic factors, rather than environmental factors, are the most likely cause of CLL. However, few known risk factors for CLL include occupational causes by exposure to certain chemicals, radiation exposure, and tobacco users.   Reports of farmers working around rubber manufacturing industries and workers with exposure to benzene and heavy solvent have shown an increased risk of CLL/SLL. However, these associations have not yet been proven.  In atomic bomb survivors, no known increase in the incidence of CLL/SLL has been noted. However, there has been an increased risk of other types of leukemia. The uranium miner population, who suffer exposure to ionizing and non-ionizing radiation, has shown increased CLL incidence. Tobacco users and cigarette smokers show a significantly elevated risk of CLL compared to non-tobacco users. The Veterans Affairs recognizes CLL as having a relationship to exposure to Agent Orange or other herbicides during military service. [1][2][3][4][5][6][7][8][9][10]

What is the most common abnormal physical examination findings in CLL/SLL?

In CLL/SLL, the most common abnormal physical examination findings are lymphadenopathy, which is seen in 50 to 90% of patients. Cervical, supraclavicular, and axillary lymph nodes are the most commonly affected sites. These increased B-cell lymphocytes eventually spill into the peripheral blood leading to the detection of lymphocytosis on a CBC. [25][26][27]

What happens after chronic lymphocytic leukemia?

After chronic lymphocytic leukemia has been diagnosed, tests are done to find out whether the cancer has spread.

Where does CLL spread?

In chronic lymphocytic leukemia ( CLL ), the leukemia cells may spread from the blood and bone marrow to other parts of the body, such as the lymph nodes, liver, and spleen. It is important to know whether the leukemia cells have spread in order to plan the best treatment.

What is stage 1 leukemia?

In stage I chronic lymphocytic leukemia , there are too many lymphocytes in the blood and the lymph nodes are larger than normal.

What is the name of the cancer in which the bone marrow makes too many lymphocytes?

Chronic lymphocytic leukemia is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell). Chronic lymphocytic leukemia (also called CLL) is a cancer of the blood and bone marrow that usually gets worse slowly. CLL is one of the most common types of leukemia in adults.

What is the disease that causes swollen lymph nodes?

Chronic lymphocytic leukemia is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell). Leukemia may affect red blood cells, white blood cells, and platelets. Signs and symptoms of chronic lymphocytic leukemia include swollen lymph nodes and feeling tired. Tests that examine the blood are used ...

What is the immunomodulating agent for CLL?

Immunomodulating agent: Lenalidomide stimulates T cells to kill leukemia cells. It may be used alone or with rituximab in patients with symptomatic or progressive, recurrent, or refractory CLL.

What is BCL2 inhibitor therapy?

BCL2 inhibitor therapy: This treatment blocks a protein called BCL2 which is found on some leukemia cells. This may kill leukemia cells and make them more sensitive to other anticancer drugs. Venetoclax is a type of BCL2 therapy used to treat symptomatic or progressive, recurrent, or refractory CLL.

What is the purpose of a detailed blood test for CLL?

These help to confirm the diagnosis of CLL and to rule out other rarer related disorders. Some more detailed tests of the genes in the lymphocytes are being developed. These will help to subdivide CLL into different categories. This may help to predict which cases will develop into the more severe type of disease, and help to guide decisions about treatment. See separate leaflet called Genetic Testing for more details.

How long does CLL last?

CLL tends to be a slowly progressing disease which can last for years. Many people with CLL die of other unrelated conditions which affect older people. The treatment of cancer and leukaemia is a developing area of medicine. New treatments continue to be developed and the information on outlook above is very general.

What happens if a cell survives leukaemia?

A leukaemia is thought to first start from one abnormal cell. What seems to happen is that certain vital genes which control how cells divide, multiply and die, are damaged or altered. This makes the cell abnormal. If the abnormal cell survives it may multiply and develop into a leukaemia. However, it is not known what causes the damage which leads to abnormal lymphocytes developing into CLL.

How common is CLL in the UK?

CLL is the most common type of leukaemia. It occurs in around 2,750 people each year in the UK. Most cases occur in people over the age of 60 years. It is rare under the age of 40 years. It is more common in males. In about 1 in 10 cases it runs in families (is familial).

Why are my lymphocytes abnormal?

The main reason for the build-up of the abnormal lymphocytes is because they live too long - they do not die after the usual lifespan of a lymphocyte.

How long does it take for a large number of white blood cells to build up in the bloodstream?

Over months or years, a large number of abnormal lymphocyte white blood cells may gradually build up in the bloodstream without causing any problems. In time, the abnormal lymphocytes may fill much of the bone marrow.

Where do abnormal lymphocytes build up?

The abnormal lymphocytes may also build up in lymph glands and in the spleen. With CLL it is also common to develop swollen glands in various parts of the body, particularly in the neck and armpits, and develop an enlarged spleen.

Why is it important to look at the white blood cell count?

We typically like to look at the white blood cell count, because there can be changes that reflect infection or progression of the disease. We like to pay attention to hemoglobin, because that can affect your performance.

What is the normal neutrophil count?

And we oftentimes hear there's no magic number in medicine, but typically we like to maintain a neutrophil count above 1,000. When it's below 1,000, we get more concerned that your response is going to be inadequate or too slow to take care of an infection before it becomes an overwhelming infection. So it's important to pay attention to our neutrophil count.

What happens when hemoglobin is below 11?

It becomes less viscous, and as a consequence it kind of compensates for a lower hemoglobin. But when the hemoglobin values get below 11 and particularly below 10, then we can start experiencing symptoms as if we were at a higher elevation, say, at 5? or 7,000 feet.

Why is it important to follow up on hemoglobin?

And that is very important and should be done in follow-up, because it gives you information about the white blood cell count, the types of white cells that are in the white cell count. It's also very important to know what your hemoglobin is. That's the protein that carries oxygen in the blood to the tissues.

Is a white blood cell the same as a neutrophil?

I think the white blood cell, the white blood cells are all not the same. There are some that are the work horses of our response to infections, the neutrophils. They're like the fire trucks. And if we don't have fire trucks in the fire stations, we can't put out fires. And the neutrophils serve that purpose.

Do CLL patients need blood tests?

Chronic lymphocytic leukemia ( CLL) patients are required to get blood tests often. Which tests should they be receiving? Which lab results should CLL patients be concerned about? Andrew Schorr, Patient Power founder and CLL patient, is joined by laboratory scientist Dr. Susan Leclair and CLL expert Dr. Thomas Kipps to discuss which blood tests are most important to CLL patients.

What is the blood test for leukemia?

Peripheral blood smear: This blood test requires just one drop of blood, which is smeared or spread out across a surface and then analyzed under a microscope. The laboratory technician looks at the appearance of the blood cells, as certain changes in the look of these cells may point toward leukemia.

What test is used to confirm leukemia?

For some types of leukemia, such as chronic lymphocytic leukemia, blood tests may be the only test needed to confirm the diagnosis (but other tests may be used to find out more about the cancer). To officially diagnose other types, such as acute lymphocytic leukemia, blood tests are typically followed by bone marrow tests.

What type of leukemia is high in blood?

The findings associated with some of the main leukemia types are summarized below. Acute myeloid leukemia (AML): Blood tests of people with AML tend to reveal high levels of immature white blood cells and low levels of red blood cells and platelets.

Why do they do a lymph node biopsy for leukemia?

When it’s used, however, it’s typically done because a lymph node has increased in size after diagnosis, raising concern that the cancer may have become more aggressive.

What is the purpose of CBC blood test?

The results of a CBC, diff and peripheral blood smear are an essential part of diagnosing leukemia and, if present, determining the type of leukemia. These blood tests tend to reveal different findings depending on the type of leukemia. The findings associated with some of the main leukemia types are summarized below.

What is the first thing you see when you have leukemia?

If you’re concerned you may have leukemia or are experiencing symptoms associated with leukemia, a physical exam is often the first method your doctor utilizes to see what’s going on. The physical exam may be focused on looking or feeling for swelling in the lymph nodes, liver and spleen.

How accurate is a lymphoma test?

This test is a very accurate indicator in determining the patient’s exact kind of lymphoma or leukemia. The test may be performed on bone marrow cells (taken during a biopsy) or blood cells (taken during a blood test). These cells are exposed to special antibodies (proteins), which will attach to specific proteins on the cells that match them. Cancer is suspected if the antibodies attach to most cells in the sample, as this indicates that the cells originated from one abnormal cell. Cancer is unlikely if different antibodies attach to different cells in the sample, as this means that there are a variety of cell types.