Chronic lymphocytic leukemia laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [3]
Overview
Laboratory findings consistent with the diagnosis of chronic lymphocytic leukemia include abnormal complete blood count, immunohistochemistry, and electrophoresis. Monoclonality of kappa and lambda producing B cells is a key diagnostic feature among patients with chronic lymphocytic leukemia.
Laboratory Findings
Complete Blood Count
- Absolute lymphocytosis (>5000 cells/μl)
- Decreased hemoglobin concentration
- Decreased platelets count
Blood Smear
- Presence of smudge cells
Metabolic Panel
- Elevated low-density lipoprotein level
Quantitative Immunoglobulin Assay
- Quantitative measurement of IgA, IgG, and IgM immunoglobulins to detect hypogammaglobulinemia
- Elevated β2-microglobulin level
Electrophoresis
- Monoclonality of kappa and lambda producing B cells is a key diagnostic feature among patients with chronic lymphocytic leukemia.
Immunohistochemistry
Peripheral Blood Cytogenetics
Peripheral blood cytogenetics and FISH determine prognosis in patients with CLL. The most important prognostic feature is the presence of absence of del(17p), which leads to the loss of TP53, a tumor suppressor gene. Presence of del(13q) is a favorable feature. Presence of del(11q) is an adverse prognostic feature.