Chronic Lymphocytic Leukaemia

This form of leukaemia is more common among the elderly. While patients are often asymptomatic initially, some may have enlarged lymph nodes and spleen. The white cell count is high, which are mature lymphocytes, and the haemoglobin and platelet count may be low. The bone marrow is infiltrated by mature lymphocytes.

• Full blood counts
• Peripheral blood film examination
• Bone marrow biopsy
• Immunophenotyping to confirm diagnosis
• Cytogenetic and Fluorescence In Situ Hybridisation (FISH) analysis

Treatments
Various combinations of targeted therapy and chemotherapy are available: 

• Mabthera/Rituximab (anti-CD20 monoclonal antibody)
• Fludarabine
• Cyclophosphamide or Chlorambucil
• Mitoxantrone
• Prednisolone or Dexamethasone
• Bendamustine
• Alemtuzumab/Campath (anti-CD52 monoclonal antibody)

Bone marrow transplantation is an option for young patients with relapsed disease 

Prognosis

• Good disease control can be achieved in most cases
• Relapses usually respond to retreatment
• FISH tests are useful in determining prognosis