Haematology  |  CLL Pathway - Signs, symptoms & staging




Haematology

CLL Pathway - Signs, symptoms & staging

Symptoms

  • In the early stages, the condition is asymptomatic, the only feature being a peripheral lymphocytosis.
  • CLL usually progresses slowly with increasing lymphocytosis, lymphadenopathy, splenomegaly, hepatomegaly and bone marrow involvement with cytopenias. Systemic symptoms (fever, weight loss and night sweats) are rare.
  • Other complications of CLL include autoimmune haemolytic anaemia, immune thrombocytopenia and hypogammaglobulinaemia with recurrent infections and herpes zoster. CLL can also transform to high-grade lymphoma (Richter’s transformation).
  • Due to the increased risk of infections prompt antibiotic therapy should be offered.


Signs

  • The following are considered as one area of organ enlargement each: neck, axillae, groin, spleen, liver e.g. bilateral cervical nodes = one site
  • Lymphadenopathy in CLL is usually bilateral, soft, mobile and painless. Unilateral lymphadenopathy is unusual in CLL and may require further investigation.

 

Stage

Definition

Prognosis (median survival – years)

A

0-2 areas of organ enlargement

>12+ years

B

3-5 areas of organ enlargement

7 years

C

Hb <100 g/L or platelets <100x109/L

(unless due to immune mechanisms)

2 years

 



Last updated : Monday, May 14, 2018
Next review date : Tuesday, May 14,2019


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