Chronic Lymphocytic Leukemia
Chronic lymphocytic leukemia (CLL) is a neoplasm of small mature B-cells and the most common leukemia affecting adults in the Western countries. The clinical course of CLL is highly variable with some patients succumbing soon after diagnosis and others having very indolent disease that may not require treatment. Interestingly, the mutational status of the immunoglobulin heavy chain variable genes (VH) expressed by CLL cells was shown approximately 15 years ago to stratify patients into good and poor prognostic groups. It appears that direct antigen stimulation is involved in the development of CLL, which could help explain why VH mutational status is related to prognosis. The significance of VH mutational status will also be compared to other newer CLL prognostic markers in clinical use such as cytogenetic abnormalities and ZAP-70 expression. In addition, the treatment of patients with CLL will be discussed.
Originally presented March 16, 2012 in Salt Lake City, Utah.
David Bahler, MD, PhD
Medical Director, Hematologic Flow Cytometry Laboratory, ARUP Laboratories
Associate Professor of Pathology, University of Utah School of Medicine
Dr. Bahler is the medical director of the Hematologic Flow Cytometry Laboratory at ARUP and an associate professor of pathology at the University of Utah School of Medicine. He is certified by the American Board of Pathology in clinical pathology, with an added qualification in hematology. Dr. Bahler received his PhD in immunology and his MD from the University of Rochester.
Martha Glenn, MD
Associate Professor of Medicine, Oncology Divison, University of Utah School of Medicine
Martha Glenn, MD, is a medical oncologist and an associate professor of internal medicine at the University of Utah School of Medicine. She treats patients with blood-related cancers such as leukemia and lymphomas. She is also participating in leukemia research and clinical trials for lymphoma at Huntsman Cancer Institute. The clinical trials are testing methods for treating low-grade lymphomas. They are called radio-labeled monoclonal treatment, and they involve tumor-specific radiation therapy. Tumor-specific treatment is more precise than some other forms of radiation therapy because it is applied directly to the cancer. Glenn completed her medical training at Columbia University in New York City and a fellowship in hematology/oncology at Memorial Sloan-Kettering Cancer Center, also in New York City.
After this presentation, participants will be able to:
- Summarize the pathologic and clinical features of chronic lymphocytic leukemia.
- Describe IGH mutational status and other chronic lymphocytic leukemia prognostic markers, and how they are related.
- Discuss the treatment of patients with chronic lymphocytic leukemia.
University of Utah School of Medicine and ARUP Laboratories