Diagnostic issues in chronic lymphocytic leukaemia (CLL)
The diagnosis of chronic lymphocytic leukaemia (CLL) is based on clinical and laboratory features. Morphology and immunophenotype are the initial diagnostic investigations. In atypical cases, these tests should be complemented with molecular genetics and/or histology to exclude other B-cell disorder...
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| Published in | Best practice & research. Clinical haematology Vol. 23; no. 1; pp. 3 - 20 |
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| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
| Published |
Netherlands
Elsevier Ltd
01.03.2010
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1521-6926 1532-1924 1532-1924 |
| DOI | 10.1016/j.beha.2010.01.001 |
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| Abstract | The diagnosis of chronic lymphocytic leukaemia (CLL) is based on clinical and laboratory features. Morphology and immunophenotype are the initial diagnostic investigations. In atypical cases, these tests should be complemented with molecular genetics and/or histology to exclude other B-cell disorders of small lymphocytes. Morphologically, CLL can be classified into typical and atypical. Immunophenotyping is the only method that can establish or confirm the diagnosis as CLL lymphocytes have a distinct immunophenotypic signature. A scoring system compounding the results with a set of markers allows firming up the diagnosis. Other immunological markers such as CD38 and ZAP-70 have an important prognostic impact. Fluorescence in situ hybridization (FISH) analysis, chiefly by detecting 17p (
TP53 locus) and 11q (
ATM) deletions and mutational status of the IgVH gene, also provides prognostic information and may determine the type of therapy. In atypical CLL, histology and/or molecular genetics may be required to exclude other B-cell disorders. |
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| AbstractList | The diagnosis of chronic lymphocytic leukaemia (CLL) is based on clinical and laboratory features. Morphology and immunophenotype are the initial diagnostic investigations. In atypical cases, these tests should be complemented with molecular genetics and/or histology to exclude other B-cell disorders of small lymphocytes. Morphologically, CLL can be classified into typical and atypical. Immunophenotyping is the only method that can establish or confirm the diagnosis as CLL lymphocytes have a distinct immunophenotypic signature. A scoring system compounding the results with a set of markers allows firming up the diagnosis. Other immunological markers such as CD38 and ZAP-70 have an important prognostic impact. Fluorescence in situ hybridization (FISH) analysis, chiefly by detecting 17p ( TP53 locus) and 11q ( ATM ) deletions and mutational status of the IgVH gene, also provides prognostic information and may determine the type of therapy. In atypical CLL, histology and/or molecular genetics may be required to exclude other B-cell disorders. The diagnosis of chronic lymphocytic leukaemia (CLL) is based on clinical and laboratory features. Morphology and immunophenotype are the initial diagnostic investigations. In atypical cases, these tests should be complemented with molecular genetics and/or histology to exclude other B-cell disorders of small lymphocytes. Morphologically, CLL can be classified into typical and atypical. Immunophenotyping is the only method that can establish or confirm the diagnosis as CLL lymphocytes have a distinct immunophenotypic signature. A scoring system compounding the results with a set of markers allows firming up the diagnosis. Other immunological markers such as CD38 and ZAP-70 have an important prognostic impact. Fluorescence in situ hybridization (FISH) analysis, chiefly by detecting 17p ( TP53 locus) and 11q ( ATM) deletions and mutational status of the IgVH gene, also provides prognostic information and may determine the type of therapy. In atypical CLL, histology and/or molecular genetics may be required to exclude other B-cell disorders. The diagnosis of chronic lymphocytic leukaemia (CLL) is based on clinical and laboratory features. Morphology and immunophenotype are the initial diagnostic investigations. In atypical cases, these tests should be complemented with molecular genetics and/or histology to exclude other B-cell disorders of small lymphocytes. Morphologically, CLL can be classified into typical and atypical. Immunophenotyping is the only method that can establish or confirm the diagnosis as CLL lymphocytes have a distinct immunophenotypic signature. A scoring system compounding the results with a set of markers allows firming up the diagnosis. Other immunological markers such as CD38 and ZAP-70 have an important prognostic impact. Fluorescence in situ hybridization (FISH) analysis, chiefly by detecting 17p (TP53 locus) and 11q (ATM) deletions and mutational status of the IgVH gene, also provides prognostic information and may determine the type of therapy. In atypical CLL, histology and/or molecular genetics may be required to exclude other B-cell disorders.The diagnosis of chronic lymphocytic leukaemia (CLL) is based on clinical and laboratory features. Morphology and immunophenotype are the initial diagnostic investigations. In atypical cases, these tests should be complemented with molecular genetics and/or histology to exclude other B-cell disorders of small lymphocytes. Morphologically, CLL can be classified into typical and atypical. Immunophenotyping is the only method that can establish or confirm the diagnosis as CLL lymphocytes have a distinct immunophenotypic signature. A scoring system compounding the results with a set of markers allows firming up the diagnosis. Other immunological markers such as CD38 and ZAP-70 have an important prognostic impact. Fluorescence in situ hybridization (FISH) analysis, chiefly by detecting 17p (TP53 locus) and 11q (ATM) deletions and mutational status of the IgVH gene, also provides prognostic information and may determine the type of therapy. In atypical CLL, histology and/or molecular genetics may be required to exclude other B-cell disorders. |
| Author | Matutes, Estella Catovsky, Daniel Wotherspoon, Andrew Attygalle, Ayoma |
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| Keywords | CLL Immunophenotype FL IgVH SLL McAb NHL MBL EBV Diagnosis SmIg CD Histology SMZL HCL-V CLL/PL BCR HCL B-PLL NCI MCL FISH IWCLL Atypical ATM PCR Cluster of differentiation Monoclonal B-cell lymphocytosis Epstein Barr virus Monoclonal antibody B-cell receptor Immunoglobulin variable region of the heavy chain Chronic lymphocytic leukaemia Fluorescence in situ hybridization National Cancer Institute B-cell prolymphocytic leukaemia Hairy cell leukaemia-variant mantle-cell lymphoma Non-Hodgkin's lymphoma CLL with increased prolymphocytes International working CLL Polymerase chain reaction Small lymphocytic lymphoma Splenic marginal zone lymphoma Ataxia telangiectasia mutated Hairy cell leukaemia Follicular lymphoma Surface immunoglobulin |
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| Title | Diagnostic issues in chronic lymphocytic leukaemia (CLL) |
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