Role Of Other Diseaserelated Complications

CLL patients are known to be at an increased risk of developing autoimmune hematologic complications. The most frequent among these is Coombs positivity with or without resulting autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). Pure red cell aplasia (PRCA) is a relatively rare complication, while immune neutropenia is extremely rare in CLL. When AIHA, ITP, or PRCA occur even in a patient who has not received any prior cytotoxic therapy, we consider these complications indications for instituting therapy.

Finally, a small minority of CLL patients develop Richter's transformation in the form of diffuse large cell lymphoma or prolymphocytic leukemia. Both of these conditions might have developed from the original CLL clone or from a new clone as a separate, new malignancy. Both of these conditions have been known to occur in patients who had received prior chemotherapy regimens for CLL, and also in previously untreated patients. These complications have been treated with a wide range of chemotherapy agents, but unfortunately none has been found to be consistently and reproducibly effective.

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