chronic%20lymphocytic%20leukemia
CHRONIC LYMPHOCYTIC LEUKEMIA

Chronic lymphocytic leukemia (CLL) is a malignant, chronic lymphoproliferative disorder characterized by proliferation and accumulation of monoclonal B-cells in the bone marrow, peripheral blood, lymph nodes, liver and spleen.

It is the most common form of adult leukemia in the Western world but rare in Asians.

Exact etiology is unknown but usually associated with genetic aberrations and lesions.

 

Surgical Intervention

Hematopoietic Stem Cell Transplantation (HSCT)
  • Should be considered in fit patients with high risk chronic lymphocytic leukemia (CLL) who experience disease relapse 24-36 months after first-line therapy, or patients with refractory CLL
  • May be considered in patients without significant comorbidities with CLL refractory to small-molecule inhibitor therapy (Eg Acalabrutinib, Duvelisib, Ibrutinib, Idelalisib, Venetoclax) 
  • May be considered as part of a clinical trial for young patients with del(17p)/TP53 mutation with good performance status and minimal comorbidities
  • Reports showed an increase in the progression-free survival rate compared to those given chemotherapy alone
  • Allogeneic HSCT is the preferred type of transplantation for CLL patients
    • Provide long-term disease control as shown in several prospective studies
    • Not recommended as a treatment option for relapsed/refractory CLL after initial therapy with purine-based regimen
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