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Chronic lymphocytic leukemia — RCPSC IM MCQ

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HardHematologyChronic lymphocytic leukemiaRCPSC IM

A 72-year-old has persistent clonal B-cell lymphocytosis of 22 x 10^9/L with a CLL phenotype, normal hemoglobin and platelets, no bulky nodes and no constitutional symptoms. What is the best management?

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Correct answer: E — Use active surveillance in the absence of immediate treatment

The best answer is “Use active surveillance in the absence of immediate treatment”. Asymptomatic early CLL without cytopenias, progressive bulky disease or constitutional symptoms is observed. Treating solely for an elevated lymphocyte count does not improve outcome and exposes the patient to toxicity. Surveillance includes symptoms, examination and blood counts, with treatment triggered by progressive marrow failure, bulky disease or disease-related symptoms.

Reference: Canadian Blood Services, transfusion reactions: https://professionaleducation.blood.ca/en/transfusion/clinical-guide/transfusion-reactions