- commonest leukemia
- often asymptomatic, incidentally diagnoses on routine FBC
- may be anemia, infection prone, weight loss, night sweats and anorexia
- blood smear : smudge cells
- complications includes AIHA, frequent infections (hypogammaglobulinemia) and marrow failure
- death is often due to infections (pneumococcus, haemophilus, meningococcus, candida or aspergillosis) or transformation to aggressive lymphoma (Richter's syndrome)
- if asymptomatic - periodic follow up
- indications for chemotherapy (Fludarabine) * to give with co-trimoxazole for PCP prophylaxis
~ night sweats, fever, rapid weight loss, progressive marrow failure, symptomatic splenomegaly
- supportive care (transfusion or IVIG if recurrent infections), steroids for AIHA
- positivity to ZAP (zeta associated protein) 70 is associated with poorer prognosis
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