January 31, 2019


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