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Chronic Lymphocytic Leukemia Case Studies

Case Studies: Treating Chronic Lymphocytic Leukemia in Elderly Patients

In this case-based interview, Matthew S. Davids, MD, MMSc, discusses the case of a 76-year-old male patient with chronic lymphocytic leukemia and the best treatment approach for elderly patients such as this one.

Treating Chronic Lymphocytic Leukemia in Elderly Patients

  • A 76-year-old male presented with symptoms of low-grade fever, (101.1o F) chills, and weight loss. The patient feels severely fatigued and required extensive rest. He was recently hospitalized for pneumonia. 
  • PMH: Hypertension controlled on candesartan, diabetes managed with metformin
  • PE: Pallor and is weak-appearing, vital signs WNL, enlarged mobile lymph nodes bilaterally (~2.0 cm), anterior cervical chain, no hepatosplenomegaly
  • PS, ECOG 2
  • Laboratory findings:
    • WBC; 18.5 X 109/L, 65% lymphocytes
    • Lymphocytes; 86.2 X 109/L
    • Hb; 12.2 g/dL
    • Platelets; 305 X 109/L
    • ANC; 120/mm3
  • Flow cytometry; CD5+, CD19+, CD23+, CD38-low,
  • Cytogenetics, IgVH mutation status, unknown
  •  β2M, 2.6 mg/L
  • BM biopsy; 50% lymphocytes
  • Diagnosis; chronic lymphocytic leukemia
  • The patient was treated with ibrutinib and achieved a complete response to therapy after 2 months
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