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Asymptomatic chronic lymphocytic leukemia — ABIM Board MCQ

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HardHematology/OncologyAsymptomatic chronic lymphocytic leukemiaABIM Board

A 69-year-old man has asymptomatic lymphocytosis found on routine testing. Leukocyte count is 38,000/mm3 with mature lymphocytes, hemoglobin is 13.8 g/dL, and platelets are 190,000/mm3. Flow cytometry shows CD5-positive monoclonal B cells. He has no bulky lymphadenopathy, B symptoms, or autoimmune cytopenias. Which of the following is the most appropriate management?

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Correct answer: A — Observation with periodic monitoring

Asymptomatic early-stage chronic lymphocytic leukemia is observed until treatment indications develop, such as symptomatic disease, progressive marrow failure, bulky nodes, or severe constitutional symptoms.

Reference: NCCN Chronic Lymphocytic Leukemia/SLL Guideline