High-Risk IgVH-Unmutated Chronic Lymphocytic Leukemia

Case:A 62-Year—Old Male WithIgVH-Unmutated CLL

• A 62-year-old male presented to PCP with complaints of extreme fatigue and night sweats
• PE: Enlarged mobile lymph nodes bilaterally (~1.5 cm), no palpable spleen or liver
• Laboratory findings:
  • WBC; 100 X 10⁹/L
  • Lymphocytes; 82 X 10⁹/L
  • Hb; 11.2 g/dL
  • Platelets; 190 X 10⁹/L
  • ANC; 1,950/mm³
  • LDH 150 U/L
• Cytogenetic; del(11q),IgVH-unmutated
• β2M, 2.9 mg/L
• Referred to community oncology who diagnosed patient with chronic lymphocytic leukemia
• Patient was started on ibrutinib + rituximab (IR)
• Rai Stage I