الفهرس 
Introduction
Incidence and EpidemiologyOnly 14 pages are availabe for public view
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Abstract
Chronic lymphocytic leukemia is the most common adult leukemia. characterized by the accumulation of long-lived, functionally inactive, mature appearing neoplastic B lymphocytes results in, immune disturbances such as hypogammaglobulinemia and auto immune phenomena. Etiology is still unknown but In contrast with other leukemias, there is no relationship between CLL and exposure to radiation or other cytotoxic agents. A genetic basis is highly likely to occur. The median age at diagnosis is now about 70 years, with only one-third of the patients being less than 60 years of age with male to female ratio 1.7/1. CLL is likely to be diagnosed when an elevated lymphocyte count is discovered incidentally during a complete blood cell count (CBC) obtained for an unrelated indication. Immunophenotyping, flowcytometry, and cytogenetic evaluation allow increased diagnostic precision and distinguish CLL from other morphologically similar appearing lymphoid malignancies.The typical immunophenotypic signature of CLL includes the pathognomic coexpression of CD5 and CDI9, as well as positivity for CD20, CD21, CD23, and CD24. The prognosis of patients with CLL is variable and related to several biologic markers associated with a more aggressive form of CLL. These include rapid lymphocyte doubling time, serum beta-2 micro-globulin (B2M), CD38 expression, unmutated (germline) immunoglobulin heavy chain gene, and ZAP70 expression , Bone marrow should also be sent for cytogenetics, and a fluorescence in situ hybridization (FISH) panel for common chromosomal abnormalities order to provide superior prognostic information. However in our locality the collected data reveald that the age of patients ranged from 39-90 years (mean +SD = 57.4+10.53),with male to female ratio 1.59:1, which is lower than that documented by Hernandez male to female ratio is 1.7:1, On assessment of their clinical condition of we found that the most common presentation is lymphadenopathy (89.1%), splenomegaly (83.5%) and hepatomegaly (49.8%) which is different from what found in USA: lymphadenopathy (87%) splenomegaly (54%), hepatomegaly (14%). However in our locality the diagnosis is still mainly based on the clinical condition together with absolute lymphocytosis and/or cell morphology (atypical lymphoid cells in the peripheral blood, bone marrow or in lymph node aspirate).in many cases only some immunophenotypic markers are done as CD3,CD4,CD5,CD10,CD19,CD20,CD22,CD23 and so we still behind the international standard for diagnosis and prognosis .