chronic lymphocytic leukemia

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chronic lymphocytic leukemia
Leukemia Practical
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.
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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(922).
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)