Lymphocytic Leukemia

8/10/2019 Lymphocytic Leukemia

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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 abloodandbone marrowdisease that

usually gets worse slowly. CLL is one of the most common types ofleukemiain adults. It often

occurs during or after middle age; it rarely occurs in children.

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Anatomy of the bone. The bone is made up of compact bone, spongy bone, and bone marrow.Compact bone makes up the outer layer of the bone. Spongy bone is found mostly at the ends of

bones and contains red marrow. Bone marrow is found in the center of most bones and has manyblood vessels. There are two types of bone marrow: red and yellow. Red marrow contains bloodstem cells that can become red blood cells, white blood cells, or platelets. Yellow marrow is

made mostly of fat.

Leukemia may affect red blood cells, white blood cells, and platelets.
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Normally, the body makes bloodstem cells(immaturecells)that become mature blood cells over

time. A blood stem cell may become amyeloidstem cell or alymphoidstem cell.

A myeloid stem cell becomes one of three types of mature blood cells:

Red blood cellsthat carryoxygenand other substances to alltissuesof the body. White blood cellsthat fightinfectionand disease.

Plateletsthat formblood clotsto stop bleeding.

A lymphoid stem cell becomes alymphoblastcell and then one of three types oflymphocytes

(white blood cells):

B lymphocytesthat makeantibodiesto help fight infection.

T lymphocytesthat help B lymphocytes make antibodies to fight infection.

Natural killer cellsthat attackcancercells andviruses.

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Blood cell development. A blood stem cell goes through several steps to become a red blood cell,

platelet, or white blood cell.

In CLL, too many blood stem cells becomeabnormallymphocytes and do not become healthywhite blood cells. The abnormal lymphocytes may also be called leukemia cells. The

lymphocytes are not able to fight infection very well. Also, as the number of lymphocytes
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Complete blood count (CBC) with differential: A procedure in which a sample of

blood is drawn and checked for the following:

o The number of red blood cells and platelets.

o The number and type of white blood cells.o The amount ofhemoglobin(theproteinthat carries oxygen) in the red blood cells.

o

The portion of the blood sample made up of red blood cells.

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Complete blood count (CBC). Blood is collected by inserting a needle into a vein and

allowing the blood to flow into a tube. The blood sample is sent to the laboratory and thered blood cells, white blood cells, and platelets are counted. The CBC is used to test for,

diagnose, and monitor many different conditions.

Immunophenotyping: Alaboratory testin which theantigensormarkerson the surface

of a blood or bone marrow cell are checked to see if they are lymphocytes or myeloid

cells. If the cells aremalignantlymphocytes (cancer), they are checked to see if they areB lymphocytes or T lymphocytes.

FISH(fluorescence in situ hybridization): A laboratory technique used to look atgenes

orchromosomesin cells and tissues. Pieces ofDNAthat contain a fluorescent dye are

made in the laboratory and added to cells or tissues on a glass slide. When these pieces of

DNA bind to specific genes or areas of chromosomes on the slide, they light up whenviewed under a microscope with a special light.
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Flow cytometry: Alaboratory testthat measures the number of cells in a sample, the

percentage of live cells in a sample, and certain characteristics of cells, such as size,

shape, and the presence oftumor markerson the cell surface. The cells are stained with a

light-sensitive dye, placed in afluid,and passed in a stream before alaseror other type oflight. The measurements are based on how the light-sensitive dye reacts to the light.

IgVH genemutationtest: A laboratory test done on a bone marrow or blood sample tocheck for an IgVH gene mutation. Patients with an IgVH gene mutation have a betterprognosis.

Bone marrow aspirationandbiopsy: The removal of bone marrow, blood, and a small

piece of bone by inserting a hollow needle into the hipbone orbreastbone.Apathologistviews the bone marrow, blood, and bone under a microscope to look for abnormal cells.

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Bone marrow aspiration and biopsy. After a small area of skin is numbed, a Jamshidineedle (a long, hollow needle) is inserted into the patients hip bone. Samples of blood,bone, and bone marrow are removed for examination under a microscope.

Certain factors affect treatment options and prognosis (chance of recovery).

Treatment options depend on:
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Thestageof the disease.

Red blood cell, white blood cell, and platelet blood counts.

Whether there are signs or symptoms, such as fever, chills, or weight loss.

Whether theliver,spleen,or lymph nodes are larger than normal.

Theresponseto initial treatment.

Whether the CLL hasrecurred(come back).

Theprognosis(chance ofrecovery)depends on:

Whether there is a change in theDNAand the type of change, if there is one.

Whether lymphocytes are spread throughout the bone marrow.

The stage of the disease.

Whether the CLL gets better with treatment or has recurred (come back).

Whether the CLLprogressestolymphomaorprolymphocytic leukemia.

The patient's general health.
http://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45885&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45885&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45885&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46312&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46312&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46312&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46593&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46593&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46593&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44085&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44085&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44085&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46556&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46556&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46556&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45849&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45849&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45849&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=454708&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=454708&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=454708&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45671&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45671&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45671&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44078&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44078&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44078&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45368&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45368&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45368&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45380&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45380&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45380&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45380&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45368&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44078&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45671&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=454708&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45849&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46556&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44085&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46593&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46312&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45885&version=Patient&language=English

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Lymphocytic Leukemia