Complications
CLL may be complicated by: (1)
- immune mediated cytopaenias:
- autoimmune haemolytic anaemia
- seen in 5 - 10 % of cases
- prevalence increases with more advance disease
- autoimmune thrombocytopenia
- pure red cell aplasia
- is associated with reticulocytopenia and the absence of erythroid precursors in the bone marrow
- seen in 1% to 6% of patients
- therapy related autoimmunity
- alkylating agents, radiotherapy, and purine analogues may be responsible
- autoimmune haemolytic anaemia
- infections
- according to the estimates, up to 70% of patients will develop infections
- second malignancies
- Kaposi sarcoma, malignant melanoma, cancers of the larynx and lung, brain cancer, and cancers of the stomach and bladder are seen in up to 11% of CLL patients
- disease transformation
- Richter syndrome - 5-10% of cases
- prolymphocytic leukaemia
Reference:
- Hallek M, Cheson BD, Catovsky D, et al. iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL. Blood. 2018 Jun 21;131(25):2745-60.
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