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Risk Stratification in Chronic Lymphocytic Leukemia

The Role of the Clinical Laboratory

Risk Assessment in CLL

Slide 4

November 2008

There are various ways to assess risk in patients with CLL. Clinically, staging methodologies have been around for a long time and have been used quite successfully. The staging techniques used have either been Rai or Binet with the Rai stage being the most common one used in this country. Morphology also offers some information as there are marrow patterns of infiltration that may give an idea for risk assessment. I will also briefly talk about fragile cells and lymphocyte doubling time. It is important to note that other aspects, such as the detection of prolymphocytes and Richter’s transformation, will not be discussed today.

Immunophenotypic markers are increasingly being used for prognostic risk factor assessment in CLL, including CD38, ZAP-70, and most recently CD49d, and molecular and other genetic-type assays, including mutational status of immunoglobulin variable heavy chain region (IgVH) as well as metaphase and FISH studies, looking for specific gene anomalies.

Risk Assessment in CLL


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