All of the following statements characterized chronic lymphocytic leukemia (CLL), EXCEPT:
Correct Answer: Hypergammaglobulinemia is usually present
Description: CLL is common in the elderly population and uncommon in younger individuals. Affected patients may initially experience hepatosplenomegaly, lymphadenopathy, pancytopenia, malaise, and weight loss. Fever does not occur and is uncharacteristic of chronic lymphocytic leukemia unless there is a superimposed infectious process. About one-fouh of patients are asymptomatic at the time of diagnosis, with the diagnosis having been made on the basis of abnormal peripheral CBC. The diagnosis often can be made from the peripheral blood smear alone without the need for a bone marrow biopsy or aspirate. This tends to be paicularly when greater than 15,000 mature lymphocytes are seen in the peripheral blood smear. The malignant lymphocytes are usually B-cells that demonstrate small amounts of monoclonal surface immunoglobulin, usually IgM. Hypogammaglobulinemia affects at least fifty percent of patients and, in combination with neutropenia, may eventually render these patients susceptible to infection. Survival in CLL is long, with a median range of between six and nine years. Treatment is non curative and is reserved for those patients who are symptomatic. Death is usually the result of infection, hemorrhage or inanition. Ref: Kipps T.J. (2010). Chapter 94. Chronic Lymphocytic Leukemia and Related Diseases. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds), Williams Hematology, 8e.
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