Fast Five Quiz: Workup for Chronic Lymphocytic Leukemia

Mohammad Muhsin Chisti, MD


November 30, 2021

Figure 2. Palpating lymph nodes.

Large, atypical cells, cleaved cells, and prolymphocytes are frequently seen on the peripheral smear of patients with CLL and may account for ≤ 55% of peripheral lymphocytes. When this percentage is surpassed, B-lymphocyte PLL is more likely than CLL.

The most valuable test to confirm a diagnosis of CLL is peripheral blood flow cytometry, which verifies the presence of circulating clonal B-lymphocytes expressing CD5, CD19, CD20(dim), CD23, and an absence of FMC-7 staining.

Clinicians may consider obtaining serum quantitative immunoglobulin levels in patients who develop repeated infections because monthly intravenous immunoglobulin administration in patients with low levels of immunoglobulin G (< 500 mg) may be helpful in reducing the frequency of infectious episodes.

Learn more about the workup for CLL.


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