Treating An Elderly Woman with Chronic Lymphocytic Leukemia

An Elderly Woman With CLL

• A 78-year—old female presented with symptoms of fatigue and loss of appetite for the past six months
• PMH: recurrent bronchitis during past 12 months, treated with antibiotics
• PE: vital signs WNL, right cervical lymphadenopathy, spleen palpable 5 cm below costal margin, otherwise well-appearing
• Laboratory findings:
  • WBC, 53,000; 76% lymphocytes
  • Hb; 10.4 g/dL
  • Platelets; 150 X 10⁹/L
  • ANC; 180/mm³
• Flow cytometry; CD5+, CD19+, CD23+
• Cytogenetics, FISH: trisomy 12; IgVH mutated
• β2M, 3.6 mg/L
• BM biopsy; diffuse infiltration by CLL
• Diagnosis; chronic lymphocytic leukemia
• The patient was treated with ibrutinib and achieved a complete response to therapy after 4 months