Relapsed Chronic Lymphocytic Leukemia
Relapsed Chronic Lymphocytic Leukemia
A 71-Year-Old Man With CLL
- A 71-yearold man presented with symptoms of persistent fatigue and weight loss
- PMH: Left axillary lymph node, 1.5 cm X 1.5 cm
- PE: Left axillary lymph node, 1.5 cm X 1.5 cm
- Laboratory findings:
- WBC, 133,000; 85% lymphocytes (ALC, 68,000 cells/mL)
- Hb; 11.4 g/dL
- Platelets; 111 X 109/L
- ANC; 174/mm3
- Molecular testing:
- Flow cytometry; CD19++, CD5+, CD20+, CD23++, CD38+
- IgVHmutated
- FISH, +12
- β2M, 3.0 mg/L
- Diagnosis; chronic lymphocytic leukemia
- BM biopsy; CLL in 88% of cells
- The patient was treated with ibrutinib and achieved a complete remission within 5 months
- 13 months later, the patient reported extreme fatigue; now with 3.0 X 3.0-cm lymph node
- Laboratory findings:
- Repeat FISH: remained +12
- WBC, 225 X 109/L
- HB, 9.6 g/dL
- Platelets, 103 X 109/L
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