A 72-year-old woman has an elevated WBC count on routine testing. The manual differential of the WBC notes an increased number of mature lymphocytes. She reports no recent illnesses or infectious symptoms, and her past medical history is significant for hypertension, osteoarthritis, chronic stable angina, and dyslipidemia. She is taking appropriate medications for these conditions and has no change in symptoms or medications. Her physical examination is normal. Which of the following features best characterizes CLL?

Correct Answer: frequently asymptomatic
Description: CLL is frequently discovered on routine evaluation of elderly patients and may not require treatment for several years. Splenomegaly, when present, rarely leads to symptoms. It is usually a disorder of B cells and is very indolent in its course. Most therapeutic regimens are designed for symptom control, not cure. Common reasons for treatment include hemolytic anemia, cytopenia, disfiguring lymphadenopathy, symptomatic organomegaly, or systemic symptoms. Chlorambucil is easy to administer, but fludarabine is considerably more effective. It requires IV administration. Maintenance therapy is not helpful.
Category: Medicine
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