�ԡ�2004��Ӣ�������ܰ�ϸ����Ѫ���ٴ�ָ�ϡ���Ԥ�����صĿ���

慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)是一种淋巴细胞克隆性增殖的肿瘤性疾病,淋巴细胞在骨髓、淋巴结、血液、脾脏、肝脏及其他器官聚集.95%以上的病例为B细胞CLL(B-CLL);仅不到5%的病例为T细胞表型(T-CLL).CLL具有显著的临床预后异质性,与亚临床期诊断的频率、疾病进展速率和治疗反应的差异有关.该疾病至少可分为预后较好与较差2大类,根据什么指标来尽早判断患者预后,是近年的研究热点.本文结合2006年美国国立综合癌症网络(NCCN)CLL临床实践指南中的"预后"部分和临床研究报道,浅谈对2004年英国慢性淋巴细胞白血病临床指南(以下简称"2004年指南")中预后因素的看法.     

�����ܰ�ϸ����Ѫ����ҩ�����ƽ�չ

慢性淋巴细胞白血病(CLL/SLL)是小细胞惰性淋巴瘤的一种,但其临床表现差异却很大.有些老年患者可能在疾病发现后数年无进展,而一些年轻患者可能诊断后疾病很快进展,出现骨髓衰竭以及其他症状.究竟哪些患者应该立即开始治疗,哪些患者可以继续观察,一直是困扰临床医师的一个难题.     

10例慢性淋巴细胞白血病免疫表型分析

目的：探讨慢性淋巴细胞白血病（CLL）的免疫分型。方法：应用流式细胞仪对10例CLL患者外周血进行淋巴细胞表面抗原检测。结果：10例CLL患者CD19抗原阳性表达率为100%。其中1例患者CD5、CD19、CD20、HLA-DR、CD3、CD13均阳性,且CD34表达率大于10%;另有1例为CD5、CD19、CD20、HLA-DR阳性且伴CD7阳性。CD5、CD19、CD20、HLA-DR同时阳性的患者为50%。结论：CLL以B细胞慢淋为主,免疫分型对慢淋的诊断及鉴别诊断具有重要意义,其免疫分型可存在伴系表达。     

慢性淋巴细胞白血病患者31例免疫表型分析

目的 探讨慢性淋巴细胞白血病(CLL)患者细胞免疫表型分型及临床意义.方法 应用流式细胞仪对31例CLL患者淋巴细胞抗原进行免疫分型分析.结果 31例患者CD19全部阳性,HLA-DR阳性率为96.8%,CD5、CD23、CD20、CD22、CD38、CD10阳性率分别为90.3%、90.3%、83.9%、54.8%、32.3%、0.0%,FMC7阳性率为6.5%. 结论 对CLL患者进行免疫表型分析,有重要诊断意义,可以检测CLL患者早期单克隆B淋巴细胞,对患者进行早期诊断、早期治疗.     

慢性淋巴细胞白血病诊断和治疗指南解读

慢性淋巴细胞白血病（CLL）是一种以成熟样小淋巴细胞在外周血、骨髓和淋巴组织蓄积,并产生相应临床症状的一种慢性B淋巴细胞增殖性疾病.目前我国CLL临床诊治工作中主要参考的权威指南包括中国、美国和国际慢淋工作组（iwCLL）发布的关于CLL的专家共识和指南.本文主要就《中国慢性淋巴细胞白血病的诊断与治疗指南》（2011年版）、iwCLL2008年发表的CLL诊疗指南以及美国国家综合癌症网络（NCCN）2014年第4版非霍奇金淋巴瘤诊疗指南中关于CLL部分并结合作者自身临床CLL诊疗经验进行解读.     

信息动态

慢性淋巴细胞白血病(CLL)是一种以成熟样小淋巴细胞在外周血、骨髓和淋巴组织蓄积,并产生相应临床症状的一种慢性B淋巴细胞增殖性疾病.目前我国CLL临床诊治工作中主要参考的权威指南包括中国、美国和国际慢淋工作组(iwCLL)发布的关于CLL的专家共识和指南.本文主要就《中国慢性淋巴细胞白血病的诊断与治疗指南》(2011年版)、iwCLL2008年发表的CLL诊疗指南以及美国国家综合癌症网络(NCCN)2014年第4版非霍奇金淋巴瘤诊疗指南中关于CLL部分并结合作者自身临床CLL诊疗经验进行解读.     

慢性淋巴细胞白血病的诊断与治疗

概述慢性淋巴细胞白血病（chronic lymphocytic leu-kemia,CLL）是一种成熟B淋巴细胞克隆增殖性肿瘤,以淋巴细胞在外周血、骨髓、脾脏和淋巴结聚集为特征。CLL是欧美国家最常见的成人白血病,占所有白血病的近30%,CLL主要发生于老年人群,初诊时〉85%的患者〉55岁,中位年龄72岁。CLL     

2004��Ӣ�������ܰ�ϸ����Ѫ���ٴ�ָ������

慢性淋巴细胞白血病(CLL)是西方国家最常见的白血病类型,占65岁以上白血病患者的40%。在WHO分类中,CLL特指B细胞恶性疾病,而以前的T-CLL被命名为T细胞幼淋白血病[1]。CLL患者是一个异质性群体,在发病形式、疾病进展、治疗反应和生存期方面具有明显的个体差异。传统的临床分期并     

老年急性淋巴细胞白血病诊断治疗进展

与儿童和成人急性淋巴细胞白血病（ALL）不同,老年ALL的文献报道相对较少,但老年ALL患者数量却可能远高于我们的估计。有调查显示在所有ALL患者中,60岁以上患者占31%。在美国,25～50岁年龄组ALL年发病率为0.4～0.6/100 000,而60岁以上则升至0.9～1.6/100 000[1]。与〈65岁成人ALL相比,老年ALL患者异质性     

Familial chronic lymphocytic leukemia

Familial aggregation of chronic lymphocytic leukemia (CLL) has been observed more frequently than familial aggregation of any other type of oncohematologic disorder. The presence of cells with a CLL-like immunophenotype (CLL-like cells) was recently documented in 13.5% healthy first-degree relatives of CLL patients. We present a family with CLL in which 2 brothers, a sister and their mother were affected.     

Epigenetics and chronic lymphocytic leukemia

The DNA methylation level in patients with chronic lymphocytic leukemia is generally lower than healthy individuals. Although DNA methylation is globally decreased, regional hypermethylation of gene promoters leads to gene silencing. Many of these genes have tumor suppressor phenotypes. Unlike mutations or deletions, hypermethylation is potentially reversible after inhibition with DNA methylation modulators. Myelodysplastic syndrome has been a model disease in which treatment of patients results in demethylation of specific genes. The story in patients with chronic lymphocytic leukemia is slowly unraveling as epigenetic modifications likely also play an important role. Ongoing clinical trials correlating clinical response to gene expression after treatment with DNA methylation inhibitors will ultimately allow us to better risk stratify and predict the subgroup of patients who will benefit from treatment with this class of drugs.     

Staging of chronic lymphocytic leukemia

One-hundred and eighty-eight patients with chronic lymphocytic leukemia were analyzed for prognosis based on Rai's staging system. It was found that stages I and II were not homogeneous as to prognosis. Stage II patients presenting with isolated splenomegaly had a long survival and were pooled with stage 0 patients (low risk group, 30% of cases, relative death rate 0.24, median survival greater than 10 yr). Stages I and II patients with a lymphocyte count higher than 40 x 10(9)/liter had a short survival and were pooled with stages III and IV patients (high risk group, 39% of cases, relative death rate 1.91, median survival 3.3 yr). Stages I and II patients with a lymphocyte count lower than 40 x 10(9)/liter made up an intermediate or standard risk group (31% of cases, relative death rate 1.00, median survival 6.2 yr). This modified staging system applied successfully to both old and young patients (more and less than 60 yr old, respectively).     

Graft-versus-leukemia in chronic lymphocytic leukemia

Immune-mediated anti-leukemia effects, often termed graft-versus-leukemia (GvL), operate after bone marrow or blood cell transplants for acute lymphoblastic leukemia, acute myelogenous leukemia and chronic myelogenous leukemia. Sometimes the magnitude of this anti-leukemia effect exceeds that of high-dose anti-leukemia drugs and radiation and can result in leukemia cure. We analyzed leukemia relapse data after transplants for chronic lymphocytic leukemia (CLL) in this context. These data support the notion of a strong GvL effect in CLL. However, as most of these data are from studies of allotransplants, it is uncertain whether GvL operates in settings where the anti-leukemia effector cells and target CLL cells are genetically identical except for leukemia-related mutations. It is also uncertain whether GvL is distinct from GvHD. These potential limitations have important implications on whether immune therapy of CLL will work in non-allotransplant settings.