By Stanley T. Crooke and Archie W. Prestayko (Eds.)
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TREATMENT Assessing the results of therapy of HCL is difficult because of variability in the clinical course. At least one spontaneous remission has been described (Bouroncle, 1979). In addition, some patients have a prolonged chronic disorder with few, if any, symptoms, whereas others have an aggressive disease with numerous systemic difficulties (Golomb et aL, 1978). A major therapeutic goal is to relieve the pancytopenia which is often severe, causing symptoms of excessive bleeding, severe infections, and anemia.
VIII. DIFFERENTIAL DIAGNOSIS The persistence of small lymphocytes in excess of 15,000 x 10 6/liter in an adult is good evidence for CLL. Microscopic examination of the bone marrow should confirm the diagnosis by showing the presence of lymphocytes representing more than 40% of the marrow cellularity. In children ill with infectious lymphocytosis or pertussis, a transient absolute lymphocytosis of small lymphocytes may exist. CLL can be differentiated from most cases of lymphosarcoma cell leukemia (LSL).
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