Complications

CLL may be complicated by:

• immune mediated cytopaenias:
  • autoimmune haemolytic anaemia
    • seen in 5 - 10 % of cases
    • prevalence increases with more advance disease
  • autoimmune thrombocytopenia
  • pure red cell aplasia
    • is associated with reticulocytopenia and the absence of erythroid precursors in the bone marrow
    • seen in 1% to 6% of patients
  • therapy related autoimmunity
    • alkylating agents, radiotherapy, and purine analogues may be responsible
• infections
  • according to the estimates, up to 70% of patients will develop infections
• second malignancies
  • Kaposi sarcoma, malignant melanoma, cancers of the larynx and lung, brain cancer, and cancers of the stomach and bladder are seen in up to 11% of CLL patients
• disease transformation
  • Richter syndrome - 5-10% of cases
  • prolymphocytic leukemia

Reference:

• (1) Yee KW, O'Brien SM. Chronic lymphocytic leukemia: diagnosis and treatment. Mayo Clin Proc. 2006;81(8):1105-29.