Leukemia is a type of cancer that originates in blood-producing organs, such as the bone marrow, and causes the uncontrolled proliferation of white blood cells. Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in adults in Western countries.
This learning program is designed to introduce you to the main clinical features of CLL. The program begins with a brief overview of the classification of CLL, including a presentation of the hierarchy of lymphomas and the subtypes of CLL. You will then learn about the tools used to establish diagnosis and determine prognosis for CLL. You will also learn about the clinical management of CLL. As you progress through the program, you will also follow the case of Richard Ellis, a 71-year-old man suffering from CLL.
Upon completion of this learning program, you will be able to::
Define CLL and identify its 2 disease subtypes.
Describe the general epidemiology trends and risk factors for CLL.
Explain the tools used to establish diagnosis and determine prognosis for CLL.
Discuss the clinical management of CLL.
WELCOME
Disclaimer
Navigation Instructions
Introduction
Learning Objectives
PATHOLOGY AND CLASSIFICATION OF CLL
Lymphomas
Hand icon: Hodgkin lymphoma
Hand icon: Non-Hodgkin lymphoma
Chronic Lymphocytic Leukemia
Side note: Digging deeper
Cellular Origins of CLL
Popup: Somatic hypermutation
Animated popup: CLL disease mechanism (Narrated)
CLL Disease Subtypes
Hand icon: IgV-unmutated CLL
Hand icon: IgV-mutated CLL
Pop Quiz
Molecular Genetics of CLL
Common Chromosomal Abnormalities in CLL
Popup: 13q deletion
Popup: 11q deletion
Popup: 17p deletion
Popup: Additional chromosome
CASE STUDY
EPIDEMIOLOGY
Incidence of CLL
Popup: Age, gender, and race
Popup: Family history and genetic predisposition
Progress Check
CASE STUDY
DIAGNOSIS AND PROGNOSIS OF CLL
Overview
Clinical Presentation and Differential Diagnosis
Popup: Clinical manifestation of other diseases
Side note: Digging deeper
Peripheral Blood Tests
Popup: CLL cells under the microscope
Pop Quiz
Immunophenotyping and Flow Cytometry
Popup: Differential diagnosis with flow cytometry
Fluorescence in situ Hybridization
Bone Marrow Aspiration and Biopsy
Hand Icon: Bone marrow aspiration
Hand Icon: Bone marrow biopsy
Staging
Popup: Rai system
Popup: Binet system
Pop Quiz
Prognostic Markers
Popup: IgV mutational status
Popup: CD38 immunophenotype
Popup: ZAP-70 expression
Popup: Chromosomal abnormalities
Popup: Levels of serum β-2 microglobulin and lymphocyte doubling time
Clinical Complications
Hand Icon: Risk of infection
Hand Icon: Autoimmunity
Hand Icon: Transformation
Hand Icon: Secondary malignancies
Progress Check
CASE STUDY
CLINICAL MANAGEMENT OF CLL
Case Study and Overview
Treatment Initiation
Chemotherapy
Popup: Alkylating agents
Popup: Purine nucleoside analogs
Popup: Bifunctional agents
Pop Quiz
Immunotherapy
Combination Therapies
Popup: Fludarabine, cyclophosphamide, and rituximab
Popup: Fludarabine and rituximab
Popup: Pentostatin, cyclophosphamide, and rituximab
Popup: Bendamustine and rituximab
Supportive Care
Pop Quiz
Recurrent Disease
Popup: Relapsed and refractory patients
Popup: Additional cytogenetic abnormalities
Progress Check
TEST YOUR ACQUIRED KNOWLEDGE
Summary
Final Assessment
END OF PROGRAM
GLOSSARY
REFERENCES
This course is accredited for continuing education (CE) by the following organizations:
Australian Nursing & Midwifery Federation
CPD Hours: 1
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