There are two types of "chronic" leukaemia. The pathophysiology and clinical features are different - so I'll look at CLL to start with. As always, the Calgary Guide has the best overview.
- 3/4 of patients are > 55 years old
- Less than 2% are younger than 45 years old.
- >20 per 100,000 over 70 years old
- Twice as common in men as women
- Most common in Western White and black populations
- Strongest risk factor is FHx
Small Lymphocytic Lymphoma
- Same disease, but in the lymph nodes rather than the blood.
- 80% are asymptomatic
- Painless, often symmetrical lymphadenopathy, splenomegaly, or hepatomegaly.
- In the latter stages of the disease patients may have anaemia, neutropenia, or thrombocytopenia due to bone marrow failure.
- Raised lymphocytes (lymphocytosis)
- Classified by Rai and Binet systems.
- To slow progression, and for palliation.
Infections - bacterial, and viral
Anaemia - bone marrow suppression, or secondary to autoimmune haemolytic anaemia, red cell aplasia,
Bleeding - bone marrow suppression or immune thrombocytopenia
Transformation- Richter's transformation into CLL. Symptoms of weight loss, fevers, night sweats, muscle wasting, and increasing hepatosplenomegaly and lymphadenopathy.