Internal Medicine

0521779407-C02 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:53

334 Chronic Lymphocytic Leukemia

CLL

■ sIg: W

■ CD5:+

■ CD23:+

■ CD20:+

■ CD10:−

■ CD103:−

HCL

■ sIg: B

■ CD5:−

■ CD23:−

■ CD20:+++

■ CD10:−

■ CD103:+

PLL

■ sIg: B

■ CD5:+/−

■ CD23:−

■ CD20:+++

■ CD10:−

■ CD103:−

SLVL

■ sIg: B

■ CD5:+/−

■ CD23:−

■ CD20:+++

■ CD10:−

■ CD103:−

MCL-L

■ sIg: B

■ CD5:+++

■ CD23:−

■ CD20:++

■ CD10:−

■ CD103:−

FCL-L

■ sIg: B

■ CD5:−

■ CD23:−

■ CD20:++++

■ CD10:−

■ CD103:−

■SIg – surface immunoglobulin, W – weak,B–bright, HCL – Hairy cell

leukemia, PLL – Prolymphocytic leukemia, SLVL – Splenic lymphoma

with villous lymphocytes, MCL – Mantle cell lymphoma-leukemic

phase, FCC – Follicular center lymphoma-leukemic phase

Staging

■Rai stage Clinical features

➣Stage 0 lymphocytosis only

➣Stage I lymphocytosis+enlarged lymph nodes

➣Stage II lymphocytosis+enlarged spleen or liver with or without

enlarged nodes

➣Stage III lymphocytosis+anemia with or without enlarged

nodes, liver, spleen

➣Stage IV lymphocytosis+thrombocytopenia with or without

enlarged nodes, spleen, liver and anemia

■Modified Rai criteria

➣Stage 0=low risk; Stage I/II=intermediate risk; Stage III/IV=

high risk