Treatment for Relapsed Chronic Lymphocytic Leukemia
Treatment for Relapsed Chronic Lymphocytic Leukemia
A 58-Year-Old Man With Relapsed CLL
- A 58-yearold man presented with symptoms of fatigue and left upper quadrant fullness
- PMH: cervical lymphadenopathy, ~2.5 cm; spleen, palpable ~6 cm below left costal margin
- PE: vital signs WNL, right cervical lymphadenopathy, spleen palpable 5 cm below costal margin, otherwise well-appearing
- Laboratory findings:
- WBC, 160,000; 68% lymphocytes (ALC, 112,000 cells/mL)
- Hb; 9.4 g/dL
- Platelets; 130 X 109/L
- ANC; 174/mm3
- Flow cytometry; CD5+, CD19+, CD23+
- Cytogenetics, IgVH unmutated; del 17p
- β2M, 4.0 mg/L
- BM biopsy; diffuse infiltration by CLL
- Diagnosis; chronic lymphocytic leukemia
- The patient was treated with fludarabine, cyclophosphamide, and rituximab and achieved a complete remission
Three years later, on routine follow up
- Laboratory findings:
- WBC; 93,000; 97% lymphocytes
- Hb; 10.4 g/dL
- Platelets; 123 X 109/L
- ANC; 1,600/mm3(WNL)
- LDH; 242 U/L
- Beta-2-microglobulin; 9.1 µg/L
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