Chronic lymphocytic leukaemia

RE: Chronic lymphocytic leukaemia

scatty — Fri, 04 Sep 2015 10:01:55 GMT

Thanks for you replies so far everyone. I think you have all confirmed what I was thinking !

RE: Chronic lymphocytic leukaemia

sarah mason — Thu, 03 Sep 2015 22:41:37 GMT

Hi Anna

globulins increasing from 56-73 in one month is concerning and the owners need to be aware of the significant risks associated with hyperviscoscity syndrome assuming this is progressing. Serum gel electrophoresis is indicated to confirm monoclonal gammopathy and you could aspirate spleen/bone marrow and flow cytometry on the blood to see if B or T cell. That can help to stage the lymphoid neoplasia.

Treatment for either indolent lymphoma or CLL is chlorambucil and pred as Martin says and is very well tolerated (well chlorambucil at least), I would definitely advise making a risk benefit assessment in this patient regarding treatment

RE: Chronic lymphocytic leukaemia

Martin Atkinson — Thu, 03 Sep 2015 10:58:43 GMT

Bone marrow biopsy might be a good idea to rule out less well differentiated cell groups but yield is often poor,

If you're convinced its CLL then I would start with Chlorambucil 2mg/msqsid q 2 weeks then eod or 20mg/msq every 2 weeks, with preds 40mg/msq sid q 7 days then 20mg/msq eod, but it can be 2-3 months to get good remission and you may need to go up to 5mg/msq on the chloramabucil. Failures to respond to this protocol should be treated with COP.

Gerry Polton is away until 14th so may be worth re-posting then if you're not happy.

RE: Chronic lymphocytic leukaemia

Anthony Dennison — Thu, 03 Sep 2015 09:47:42 GMT

Might be worth doing a gel electrophoresis to determine whether it is monoclonal?