Optimizing Targeted Therapy in IgVH-Unmutated CLL
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
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