> For the complete documentation index, see [llms.txt](https://thisispiggy.gitbook.io/my-wiki/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://thisispiggy.gitbook.io/my-wiki/01-step-1/heme/17-chronic-leukemia.md).

# 17 Chronic Leukemia

## CML

![](https://f001.backblazeb2.com/file/wikiFiles/XV1Bgit.jpg)

* granulocytes: CML, leukemia since WBC

![](https://f001.backblazeb2.com/file/wikiFiles/40mlYAf.jpg)

* leukemia: increased WBC in blood
* myeloproliferative disorder: over proliferation of cells

![](https://f001.backblazeb2.com/file/wikiFiles/plLX9DY.jpg)

* nl WBC 10k
* increase in every stage of neutrophils
* RBC low

![](https://f001.backblazeb2.com/file/wikiFiles/yqe1HV8.jpg)

* number of phases
* chronic: nonspecific phase

![](https://f001.backblazeb2.com/file/wikiFiles/VQRVJIY.jpg)

* important to distinguish AML from left shift
* must exclude left shift to diagnose CML

![](https://f001.backblazeb2.com/file/wikiFiles/79bFjl7.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/FHHFXEF.jpg)

* BCL from 9 and ABL from 22
* translocation: BCL-ABL next to each other on 22

![](https://f001.backblazeb2.com/file/wikiFiles/s4KFG8J.jpg)

* oral pills

## CLL

![](https://f001.backblazeb2.com/file/wikiFiles/0KAsnGN.jpg)

* naive lymphocytes not lymphoblasts 
* CD5: T cell marker
* CLL: a confused malignancy, not sure if it wants to be leukemia or lymphoma

![](https://f001.backblazeb2.com/file/wikiFiles/Buo3apt.jpg)

* can have large lymph nodes like SLL

![](https://f001.backblazeb2.com/file/wikiFiles/GlgrjDs.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/Y3hClyT.jpg)

* lymphocytes disrupted

![](https://f001.backblazeb2.com/file/wikiFiles/VRblUTT.jpg)

* feared complication

![](https://f001.backblazeb2.com/file/wikiFiles/Wk0YGee.jpg)

* related to CLL
* CLL, leukemia: high WBC
* SLL, lymphoma: swollen lymph nodes with mild lymphocytosis

## Hairy Cell

![](https://f001.backblazeb2.com/file/wikiFiles/3GmDTFh.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/hwPAYxh.jpg)

* WBC fill up red pulp so big that obliterates white pulp

![](https://f001.backblazeb2.com/file/wikiFiles/LO2Unts.jpg)

* abd pain from splenomegaly

![](https://f001.backblazeb2.com/file/wikiFiles/oQQSrMz.jpg)