TY - CHAP M1 - Book, Section TI - Chronic Lymphocytic Leukemia A1 - Woyach, Jennifer A. A1 - Byrd, John C. A2 - Jameson, J. Larry A2 - Fauci, Anthony S. A2 - Kasper, Dennis L. A2 - Hauser, Stephen L. A2 - Longo, Dan L. A2 - Loscalzo, Joseph Y1 - 2018 N1 - T2 - Harrison's Principles of Internal Medicine, 20e AB - Chronic lymphocytic leukemia (CLL) is a monoclonal proliferation of mature B lymphocytes defined by an absolute number of malignant cells in the blood (5 × 109/mL). The presence of malignant B cells under this count in the blood without nodal, spleen, or liver involvement and absent cytopenias is a precursor of this disease called monoclonal B-cell lymphocytosis (MBL) with ~1–2% chance per year of progressing to overt CLL. CLL is a heterogeneous disease in terms of natural history, with some patients presenting asymptomatically and never requiring therapy, whereas others present with symptomatic disease, require multiple lines of therapy, and eventually die of their disease. Over the past 10–15 years, the understanding of CLL origin and biology has grown exponentially, leading first to more refined disease definition, prognostic markers, and, subsequently, introduction of novel therapies that have significantly changed the natural history of this disease. In this chapter, we review the epidemiology, biology, and management of CLL, with a focus on new knowledge that is currently changing standards of care. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1156754614 ER -