Chronic Intermittent Leukocytosis Evaluation

Diagnostic Criteria

• The American Society of Hematology suggests that Chronic Lymphocytic Leukemia (CLL) should be suspected with persistent lymphocytosis ≥5 × 10^9/L (5,000/μL) not explained by other disorders 1
• Characteristic findings on peripheral smear include predominance of small, mature-appearing lymphocytes, and flow cytometry showing the composite immunophenotype (CD5+, CD19+, CD20+ (low), CD23+, sIg low, CD79b low) can distinguish CLL from other lymphoproliferative disorders 1

Disease Monitoring and Prognosis

• Bone marrow examination may be informative in patients older than 60 years or those with systemic symptoms 2
• Progressive lymphocytosis with an increase of more than 50% over a 2-month period or lymphocyte doubling time of less than 6 months may indicate need for treatment in CLL 1