Chronic lymphocytic leukemia
 
Incidence, epidemiology, and demographics
B-cell chronic lymphocytic leukemia (CLL) is a lymphoproliferative disorder manifested by a clonal expansion of mature, long-lived, B lymphocytes. The disease is identical to small lymphocytic leukemia (SLL); the clinical distinction is whether the leukemic (blood and marrow) or the nodal components of the disease predominate in a given patient. The 2001 World Health Organization classification scheme considers CLL and SLL in one category (CLL/SLL) because of shared clinicopathologic features. The mechanisms of why clonal B cells predominate in marrow or node are not clearly understood, but one possibility may be the ability of B lymphocytes to "home" to certain . . . [Full Text of this Article]

Familial CLL

Diagnosis
 
Differential diagnosis: cytogenetic, immunophenotypic, and molecular aspects
Is there a minimum level of blood B cells necessary for diagnosis of CLL?
Monoclonal B-cell lymphocytosis

Clinical and laboratory features
 

Staging
 

Prognostic factors
 
The case for prognostic factors in CLL
Traditional prognostic factors
Novel biomarker prognostic factors in assessing high-risk subgroups of patients with CLL
IgVH mutation
CD38, CD49d, and ZAP-70
Fluorescence in situ hybridization
Practical use of prognostic markers (traditional or novel) for newly diagnosed CLL versus previously treated or relapsed/refractory CLL
Prognostic models
Multivariate model using traditional prognostic factors
Multivariate models using novel biomarkers

Therapy
 
Initial therapy
Alkylator-based therapy
Purine analogs
Rituximab
Combination purine analog–based chemotherapy and chemoimmunotherapy
Other purine analogs
Alemtuzumab
Bendamustine
Relapsed/refractory CLL: workup and treatment options

Approach to newly diagnosed patients with high-risk disease
 
Options for the relapsed/refractory CLL patient
Lenalidomide
Flavopiridol
HuMax-CD20 (ofatumumab)
Stem cell transplantation

Complications of CLL
 
Autoimmune complications
Infectious complications
Transformation to prolymphocytic leukemia or Richter transformation
Other second malignancies

Quality-of-life issues
 

Other indolent cell leukemias
 
Prolymphocytic leukemia
Hairy cell leukemia
Marginal zone lymphoma
Lymphoplasmacytic lymphoma
T-cell CLL and other chronic T-cell leukemias
Mantle cell lymphoma

The future