Case 132 – Update 4!

The peripheral blood flow cytometry has demonstrated a CLL score of 5/5 confirming the suspected diagnosis of CLL.

Cytogenetics / biomarkers:

NO TP53 deletion/disruption, IGHV UNmutated, 11q deletion

His staging CT (neck, chest abdo pelvis) demonstrates widespread bilateral lymphadenopathy (stage III) with the largest measuring 4cm intra-abdominal nodes and moderate splenomegaly at 15cm.

You review him in a follow-up clinic to go through the above results and he informs you he has had a further 1/4 stone of weight loss in the past 6 weeks. No bleeding issues.

FBC: Hb 108, Plts 50, WCC 60, neuts 2.1, Lymph 54

B2 microglobulin 4. Renal / liver function normal. HIV / hep B/C negative.

Questions?

  1. How would you manage this man?
  2. If you plan to start treatment what option would you choose and why?

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