Chronic Lymphocytic Leukaemia (CLL) – An Overview

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

Chronic Lymphocytic Leukaemia (CLL) – An Overview

Nadeem Ikram; Khalid Hassan*; and Samina Tufail
Department of Pathology, District Headquarters Hospital, Rawalpindi.
* Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad.
Chronic Lymphocytic Leukaemia (CLL), a
haematological malignancy of old age, is viewed by
clinicians and investigators as an uninspiring disease
with an indolent course . But the last ten years have
witnessed renewed interest in its biology and
treatment.1 CLL is characterized by proliferation,
accumulation and sustained increase of
morphologically mature but functionally incompetent
lymphocytes. Peripheral lymphocytosis is
accompanied by an accumulation of similar cells in the
bone marrow, spleen, liver, lymph nodes and other
lymphoid organs. The cause of this disease is
unknown, although it appears likely that the genetic
factors contribute to its development. The majority of
cases involve B-lymphocytes and the disease is
thought to arise by clonal expansion of a rare CD 5
positive B cells. At the time of presentation the
patients may be completely free of symptoms,
ostensibly feeling quite well and having no
abnormality at physical examination; on the other
extreme, they may have profound weakness, night
sweats, fever, weight loss, large bulky and generalized
lymphadenopathy with enlarged spleen and liver.
The diagnosis of CLL does not imply the need


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