chronic lymphocytic leukemia

1. Leukemia Practical chronic lymphocytic leukemia These mature lymphocytes are increased markedly in number. They are indicative of chronic lymphocytic leukemia, a disease most often seen in older adults. This disease responds poorly to treatment, but it is indolent. chronic myelogenous leukemia (CML) There are numerous granulocytic forms seen here, including immature myeloid cells and bands. This condition is one of the myeloproliferative states and is known as chronic myelogenous leukemia (CML) that is most prevalent in middle-aged adults. A useful test to help distinguish this disease is the leukocyte alkaline phosphatase (LAP) score, which should be low with CML and high with a leukemoid reaction. CML Here is another view of a peripheral blood smear in a patient with CML. Often, the numbers of basophils and eosinophils, as well as bands and more immature myeloid cells (metamyelocytes and myelocytes) are increased. Unlike AML, there are not many blasts with CML. The CBC here is from a patient with CML. Note the markedly increased WBC count. 1

2. Myeloid cells of CML Myeloid cells of CML are also characterized by the Philadelphia chromosome (Ph1) on karyotyping. This is a translocation of a portion of the q arm of chromosome 22 to the q arm of chromosome 9, designated t(9:22). Hairy cell leukemia • Hairy cell leukemia (HCL) is a chronic lymphoid leukemia • Hairy cell leukemia with hairy cytoplasmic projections on its surface • identified by immunoglobulin gene rearrangements resulting in a phenotype • B-cell expression of surface antigens, which reflect the differentiation between the immature B-cell of chronic lymphocytic leukemia and the plasma cell of multiple myeloma Hairy cell leukemia ( with oval nucleus) Hairy cell leukemia ( reniform nucleus)