What describes the typical presentation of chronic lymphocytic leukemia?

What describes the typical presentation of chronic lymphocytic leukemia?

• A. Often asymptomatic with lymphocytosis in older adults; may have painless lymphadenopathy; smudge cells on smear
• B. Severe thrombocytopenia with mucosal bleeding
• C. Bone pain and hypercalcemia
• D. Rapidly enlarging spleen with pancreatic insufficiency

Answer: (A)

Chronic lymphocytic leukemia is a slow-progressing B-cell cancer most often seen in older adults. Its typical presentation is an unexpected finding of lymphocytosis with mature-appearing lymphocytes, often discovered during routine blood work and accompanied by little or no symptoms. Painless lymphadenopathy is common, and some patients have splenomegaly. A peripheral smear frequently shows smudge cells, which are fragile lymphocytes that smear cells leave behind when prepared. Because the disease often progresses slowly, many individuals are asymptomatic at diagnosis, though infections can occur later due to hypogammaglobulinemia. The other scenarios describe features more characteristic of different conditions: mucosal bleeding from severe thrombocytopenia points away from CLL, bone pain with hypercalcemia suggests disorders like multiple myeloma, and a rapidly enlarging spleen with pancreatic insufficiency is not typical of CLL.

Chronic lymphocytic leukemia is a slow-progressing B-cell cancer most often seen in older adults. Its typical presentation is an unexpected finding of lymphocytosis with mature-appearing lymphocytes, often discovered during routine blood work and accompanied by little or no symptoms. Painless lymphadenopathy is common, and some patients have splenomegaly. A peripheral smear frequently shows smudge cells, which are fragile lymphocytes that smear cells leave behind when prepared. Because the disease often progresses slowly, many individuals are asymptomatic at diagnosis, though infections can occur later due to hypogammaglobulinemia. The other scenarios describe features more characteristic of different conditions: mucosal bleeding from severe thrombocytopenia points away from CLL, bone pain with hypercalcemia suggests disorders like multiple myeloma, and a rapidly enlarging spleen with pancreatic insufficiency is not typical of CLL.