What is the diagnosis of CLL?

To diagnose CLL, the following must be present:

  • A blood smear showing typical leukaemia cells. These are small, mature‑looking lymphocytes with a narrow border of cytoplasm and a dense nucleus lacking discernible nucleoli and having partially aggregated chromatin (Figure 2).
  • Presence of ≥5×109/L of genetically identical B-cells in the peripheral blood

If large, atypical lymphocytes are seen in the blood, they must not exceed 55% of all the blood cells.

Figure 2        Normal lymphocyte cell and CLL lymphocyte cell


Normal lymphocyte

CLL lymphocyte cell

Courtesy of https://en.wikipedia.org/wiki/Chronic_lymphocytic_leukemia

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