Chronic lymphatic leukemia

Chronic lymphatic leukemia is characterized by the excessive accumulation of mature appearing lymphocytes in the peripheral blood, associated with infiltration of the bone marrow, spleen and lymph nodes. More than 90% of this disease is due to expansion of B lymphocytes. Some clinical features are common form of chronic leukemia, found more in males than females, bleeding manifestations are extremely common, slowly developing anaemia and about 25% of the patients are asymptomatic. The main investigation of chronic lymphatic leukemia are mild to moderate anaemia, total leukocyte is raised to the range of 50,000-2,00,000 per microlitre, peripheral smear examination which results more than 95% of the cells are mature appearing lymphocytes of small variety, bone marrow is hyper cellular with infiltration of small and medium sized lymphocytes, direct coomb’s test may be positive indicating an autoimmune hemolytic process, lymph node biopsy shoes well differentiated ,small non-cleaved lymphocytes, serum folic acid levels are low. But clinical staging includes three stages such as stage A, stage B, stage C. In stage A there is no anaemia or thrombocytopenia but there will be a less than 3 areas of lymphoid enlargement. In stag B also there is no anaemia or thrombocytopenia but here unlike stage A 3 or more areas of lymphoid enlargement. In stage C, anaemia or thrombocytopenia are present. While coming to treatment stage A requires no treatment but only reassurance, in stage B fludarabine is the drug of choice in young patients, but in stage C chlorambucil is the drug of the choice, fludarabine in young patients, packed cell transfusion for anaemia.