Last reviewed 01/2018
CLL usually has an insidious onset. Approximately 70 - 80% of patients are diagnosed incidentally when they are found to have lymphocytosis (1).
Rapidly progressive CLL occurs occasionally and is characterised by larger, less mature - appearing lymphocytes - "prolymphocytic" leukaemia.
When patients present with symptoms, the disease tends to have developed into a more advanced stage (2).
Typical clinical features of CLL include:
- non-specific symptoms -
- “B” symptoms (lethargy, weight loss, fever and night sweats) and infections
- of anaemia and thrombocytopenia - which may be autoimmune.
- occurs in 80% of cases.
- typically, moderate enlargement, affecting nodes in the neck, axilla and groin.
- classically, symmetrical with non-tender, rubbery nodes
- may have developed over a period of months or years.
- in 50% of cases.
- skin lesions - pruritus, Herpes zoster, generalised infiltration (l'homme rouge, usually associated with pruritus), vesibullous lesions
- B symptoms are not common but if present it might indicate that CLL has transformed into an aggressive large B-cell lymphoma (Richter’s transformation) (2)
clinical features of severe bone marrow failure