RT Book, Section
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
SR Print(0)
ID 1156754614
T1 Chronic Lymphocytic Leukemia
T2 Harrison's Principles of Internal Medicine, 20e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259644016
LK accesspharmacy.mhmedical.com/content.aspx?aid=1156754614
RD 2024/04/24
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.