Chronic lymphocytic leukemia diagnostic study of choice: Difference between revisions
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==Overview== | ==Overview== | ||
The diagnostic study of choice in chronic lymphocytic leukemia is peripheral | The [[Diagnosis|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]] ([[Complete blood count|CBC]]) with differential and peripheral smear [[flow cytometry]]. | ||
==Diagnostic study of choice== | ==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 | *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 (biology)|cells]] 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: | *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><ref name="pmid18216293">{{cite journal |vauthors=Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, Hillmen P, Keating MJ, Montserrat E, Rai KR, Kipps TJ |title=Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer *Institute-Working Group 1996 guidelines |journal=Blood |volume=111 |issue=12 |pages=5446–56 |date=June 2008 |pmid=18216293 |pmc=2972576 |doi=10.1182/blood-2007-06-093906 |url=}}</ref><ref name="pmid25908509">{{cite journal |vauthors=Hallek M |title=Chronic lymphocytic leukemia: 2015 Update on diagnosis, risk stratification, and treatment |journal=Am. J. Hematol. |volume=90 |issue=5 |pages=446–60 |date=May 2015 |pmid=25908509 |doi=10.1002/ajh.23979 |url=}}</ref><ref name="pmid8652811">{{cite journal |vauthors=Cheson BD, Bennett JM, Grever M, Kay N, Keating MJ, O'Brien S, Rai KR |title=National Cancer Institute-sponsored Working Group guidelines for chronic lymphocytic leukemia: revised guidelines for diagnosis and treatment |journal=Blood |volume=87 |issue=12 |pages=4990–7 |date=June 1996 |pmid=8652811 |doi= |url=}}</ref> | ||
* Complete blood count (CBC) with differential: Absolute lymphocytosis ≥5000 B-lymphocytes/µL X ≥ 3 months | **Complete blood count ([[Complete blood count|CBC]]) with differential: Absolute lymphocytosis ≥5000 B-lymphocytes/µL X ≥ 3 months | ||
* Flow cytometry: | **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-lymphocytosis <5000/µL without cytopenia, 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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==References== | ==References== | ||
Latest revision as of 15:52, 28 February 2019
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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 cells 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][3][4][5]
- Presence of clonal B-lymphocytosis <5000/µL without cytopenia, 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.[7]
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.
- ↑ Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, Hillmen P, Keating MJ, Montserrat E, Rai KR, Kipps TJ (June 2008). "Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer *Institute-Working Group 1996 guidelines". Blood. 111 (12): 5446–56. doi:10.1182/blood-2007-06-093906. PMC 2972576. PMID 18216293.
- ↑ Hallek M (May 2015). "Chronic lymphocytic leukemia: 2015 Update on diagnosis, risk stratification, and treatment". Am. J. Hematol. 90 (5): 446–60. doi:10.1002/ajh.23979. PMID 25908509.
- ↑ Cheson BD, Bennett JM, Grever M, Kay N, Keating MJ, O'Brien S, Rai KR (June 1996). "National Cancer Institute-sponsored Working Group guidelines for chronic lymphocytic leukemia: revised guidelines for diagnosis and treatment". Blood. 87 (12): 4990–7. PMID 8652811.
- ↑ 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.