Treating Chronic Lymphocytic Leukemia in Elderly Patients
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Treating Chronic Lymphocytic Leukemia in Elderly Patients
A 76-year-old male presented with symptoms of low-grade fever, (101.1oF) chills, and weight loss. The patient feels severely fatigued and required extensive rest. He was recently hospitalized for pneumonia.
PMH: Hypertension controlled on candesartan, diabetes managed with metformin
PE: Pallor and is weak-appearing, vital signs WNL, enlarged mobile lymph nodes bilaterally (~2.0 cm), anterior cervical chain, no hepatosplenomegaly
PS, ECOG 2
Laboratory findings:
WBC; 18.5 X 109/L, 65% lymphocytes
Lymphocytes; 86.2 X 109/L
Hb; 12.2 g/dL
Platelets; 305 X 109/L
ANC; 120/mm3
Flow cytometry; CD5+, CD19+, CD23+, CD38-low,
Cytogenetics, IgVH mutation status, unknown
β2M, 2.6 mg/L
BM biopsy; 50% lymphocytes
Diagnosis; chronic lymphocytic leukemia
The patient was treated with ibrutinib and achieved a complete response to therapy after 2 months