Chronic lymphocytic leukemia (CLL) is a malignant disorder characterized by an accumulation of B lymphocytes in the body. The final diagnosis is established using flow cytometry demonstrating a monoclonal population of lymphocytes. In recent years, a significant number of molecular markers have been established as relevant in establishing the prognosis of patients with CLL. These markers include the immunoglobulin heavy chain (IGHV) mutation status, the serum level of b2 microglobulin, the presence of the TP53 oncogene mutation (associated with deletion of the short segment of chromosome 17), and mutations including suppression of (11q), trisomy (+12) and del (13q). Early initiation of chemotherapy has shown no benefit in CLL and may even increase mortality in the short term. Criteria used to define when to start treating a patient include significant weight loss, fever of tumor origin, night sweats, progressive cytopenias, progressive organomegaly, 50% or more increase in neoplastic lymphocytes in less than six months. , presence of significant autoimmune disease and finally patients with high-risk molecular characteristics.
