ONCAlert | Upfront Therapy for mRCC
Chronic Lymphocytic Leukemia Case Studies

Case Studies: Optimizing Targeted Therapy in IgVH-Unmutated CLL

William Wierda, MD, PhD, reviews the diagnosis and treatment of a 58-year-old woman who presents with IgVH-unmutated chronic lymphocytic leukemia.

Optimizing Targeted Therapy in IgVH-Unmutated CLL

A 58-Year Old Female with IgVH-Unmutetd CLL

  • A 58-year-old female with incidentally noted lymphocytosis on routine
  • PMH: hypercholesterolemia managed on simvistatin, mild osteoarthritis
  • PE: 1.0-cm cervical node, no palpable spleen or liver
  • PS, ECOG 0
  • Laboratory findings:
    • WBC; 45 X 109/L, 85% lymphocytes
    • Lymphocytes; 86.2 X 109/L
    • Hb; 13.9 g/dL
    • Platelets; 274 X 109/L
    • ANC; 1,950/mm3
    • LDH 160 U/L
  • Flow cytometry; CD5+, CD19+, CD20+(dim), CD23+, slg+ (dim), ZAP70+
  • Cytogenetics by FISH; del(17p), trisomy 12, IgVH unmutated
  • β2M, 3.6 mg/L
  • BM biopsy; 70% lymphocytes, diffuse pattern
  • Diagnosis; chronic lymphocytic leukemia
  • Observed for over 2 years, then developed progressive sever fatigue and night sweats
  • The patient was treated with ibrutinib and achieved a complete response to therapy after 2 months
Publications
Copyright © TargetedOnc 2019 Intellisphere, LLC. All Rights Reserved.