Progressive proliferation and accumulation of mature (usually) B-lymphocytes found in blood, bone marrow, lymph nodes liver and spleen

Unknown, small proportion familial, no link with radiation, chemicals, drugs 

Commonest leukaemia in adults. Increasing incidence with age

Often asymptomatic, infection, anaemia, bleeding, anorexia, sweating, malaise

Bloods: FBC – lymphocytosis, anaemia, low platelets

Blood Film: Smudge Cells

Bone Marrow Aspirate: Infiltration of lymphocytes 

Conservative: Usually ‘watch and wait’

Medical: Chemotherapy, Allogeneic stem cell transplantation, Blood transfusion

Incurable unless transplanted

Median survival varies between 1 year and >13 years depending on staging 

Depends on choice of chemotherapy: gut toxicity, infections, anaemia, bleeding, hair loss, marrow failure, dysplasia caused by chemotherapy, secondary malignancy