Chronic Leukaemia

Chronic Leukaemia

– CLL (Chronic Lymphocytic Leukaemia):

• 40% of elderly leukaemia
• Often asymptomatic
• Symptoms: lymphadenopathy, weight loss, sweating Lymphocyte count >5×10^9/L
• Management:

If asymptomatic: 6-monthly FBC monitoring

Influenza/pneumococcal vaccines (not shingles)

Prompt infection treatment

• Prognosis >10 years possible

– CML (Chronic Myeloid Leukaemia):

• Rare in children
• Typically presents at age 65
• 20% found incidentally
• Symptoms: splenomegaly, bleeding abnormalities Investigations:

WBC >50×10^9/L

Philadelphia chromosome

• Treatment based on disease phase:

Chronic phase (90%): tyrosine kinase inhibitors (TKIs)

Accelerated phase: stem cell transplant/second-gen TKIs

Blast phase: chemotherapy