ISSN 2398-2969      

Chronic lymphoid leukemia (CLL)

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Synonym(s): CLL


Introduction

  • More common than acute lymphoid leukemia Acute lymphoblastic leukemia.
  • Cause: neoplastic transformation and proliferation of late precursor lymphoid cells in the bone marrow or in the spleen.
  • Signs: slow progression and mild clinical signs. May be incidental finding.
  • Diagnosis: predominance of mature lymphoid cells in bone marrow and marked lymphocytosis. Flow cytometry and PCR for antigen rearrangement (PARR) may help in definitive diagnosis. 
  • Treatment: supportive, specific cytotoxic agents.
  • Prognosis: reasonable.
Print off the owner factsheet on Canine leukaemia to give to your client.

Pathogenesis

Etiology

  • Unknown.

Pathophysiology

  • Replacement of normal bone marrow tissue with neoplastic cells → myelosuppression → anemia, thrombocytopenia, granulocytopenia.
  • Transformation of late precursor cells → proliferation of mature, differentiated cells → chronic leukemia→ less severe cytopenia.
  • Excessive numbers of circulating cells/hyperproteinemia → hyperviscosity → decreased oxygen transport to capillary beds → microthrombi of tumor cells.
  • Production of humoral factors → stimulation of osteoclasts → hypercalcemia of malignancy → polyuria/polydipsia → renal failure.

Timecourse

  • Months to years.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Conway E A, Waugh E M, Knottenbelt C (2020) A case of T-cell chronic lymphocytic leukemia progressing to Richter syndrome with central nervous system involvement in a dog. Vet Clin Pathol 49(1),147-152 PubMed
  • Rout E D, Moore A R, Burnett R C, Labadie J D, Hughes K L, Navin P A, Yoshimoto J A, Avery P R, Avery A C (2020) Polyclonal B-cell lymphocytosis in English bulldogs. J Vet Intern Med 34(6), 2622-2635 PubMed
  • Museux K, Turinelli V, Rosenberg D, Rodriguez Piñeiro I (2019) Chronic lymphopenia and neutropenia in a dog with large granular lymphocytic leukemia. Vet Clin Pathol 48(4),721-724 PubMed
  • Elliott J, Villiers E (2018) Indolent, T-cell, large granular lymphocytic leukaemia in a dog presenting with severe neutropenia and an absence of lymphocytosis. Open Vet J 8(2), 118-124 PubMed
  • Comazzi S, Martini V, Riondato F, Poggi A, Stefanello D, Marconato L, Albonico F, Gelain M E (2017) Chronic lymphocytic leukemia transformation into high-grade lymphoma: a description of Richter's syndrome in eight dogs. Vet Comp Oncol 15(2), 366-373 PubMed
  • Bromberek J L, Rout E D, Agnew M R, Yoshimoto J, Morley P S, Avery A C (2016) Breed Distribution and Clinical Characteristics of B Cell Chronic Lymphocytic Leukemia in Dogs. J Vet Intern Med 30(1), 215-222 PubMed
  • Comazzi S, Aresu L, Marconato L (2015) Transformation of Canine Lymphoma/Leukemia to More Aggressive Diseases: Anecdotes or Reality? Front Vet Sci 2, 42 PubMed
  • Comazzi S, Gelain M E, Martini V, Riondato F, Miniscalco B, Marconato L, Stefanello D, Mortarino M (2011) Immunophenotype predicts survival time in dogs with chronic lymphocytic leukemia. J Vet Intern Med 25(1),100-106 PubMed.   
  • Fujino Y,  Sawamura S, Kurakawa N,  Hisasue M, Masuda K, Ohno K, Tsujimoto H (2004) Treatment of chronic lymphocytic leukaemia in three dogs with melphalan and prednisolone. J Small Anim Pract 45(6), 298-303 PubMed.
  • Workman H C, Vernau W (2003) Chronic lymphocytic leukemia in dogs and cats: the veterinary perspective. Vet Clin North Am Small Anim Pract 33(6),1379-1399 PubMed.  

Other Sources of Information 

  • Vail D M, Pinkerton M, Young K M (2020) Cancer chemotherapy. In: Small Animal Clinical Oncology. 6th edn. Eds Withrow & MacEwen. Elsevier Saunders, St. Louis. pp 712-715. 
  • Presley R H, Mackin A, Vernau A (2006) Lymphoid Leukemia in Dogs. Compendium Dec 2006 831-849. 

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