Provider Connections: Dr. Neil Kay on Newly Diagnosed Chronic Lymphocytic Leukemia, Watch and Wait
Special due to Goldman Philanthropic Partnerships for funding this sequence.
Introduction
Dr. Neil Kay introduces Chronic Lymphocytic Leukemia (CLL), the most typical leukemia within the Northern Hemisphere, specializing in the preliminary analysis section.
How CLL is Diagnosed
An elevated white cell depend usually results in a analysis, that includes the "gold standard" stream cytometry take a look at used to map cell receptors.
History & Physical Examination
What docs search for throughout an preliminary examination, together with affected person age, signs (fever, weight reduction, fatigue), and bodily indicators like an enlarged spleen.
Risks Without Treatment
Why docs monitor different well being points, as CLL sufferers have a better threat of infections and secondary cancers.
The "Watch and Wait" Strategy
Vast majority of sufferers stay on this section for years because of the slow-growing nature of the lymphocytes.
Rai Staging (Stages 0–4)
Breakdown of the Rai staging system developed within the Nineteen Seventies, categorizing threat from Stage 0 (low) to Stage 4 (excessive).
FISH Testing & Chromosomes
Fluorescence In Situ Hybridization (FISH) detects genetic defects in chromosomes 11, 12, 13, and 17 to foretell illness aggression.
CLL International Prognostic Index (CLL-IPI)
An in depth have a look at the 0–10 scoring system that makes use of 5 components, together with TP53 and IGHV standing to estimate survival and development.
What to Expect at Follow-up Visits
The typical schedule for clinic visits (each 3–6 months initially) and the usual blood panels (CBC, liver, and renal operate) carried out.
Monitoring Secondary Complications
Complications related to CLL even when the illness isn’t progressing.
Managing the "Smoldering" Anxiety
Dr. Kay acknowledges the stress of "Watch and Wait" and presents reassurance that very efficient therapies are prepared if the illness finally progresses.
Acknowledgments & Conclusion
A thanks to the sufferers, the Mayo Clinic staff, and the Goldman Philanthropic Partnerships for his or her assist in creating the video sequence.
00:00 – Introduction
00:58 – How CLL is Diagnosed
01:53 – History & Physical Examination
02:47 – Risks Without Treatment
03:22 – The "Watch and Wait" Strategy
04:04 – Rai Staging (Stages 0–4)
05:40 – FISH Testing & Chromosomes
06:41 – CLL International Prognostic Index (CLL-IPI)
08:14 – What to Expect at Follow-up Visits
09:24 – Monitoring Secondary Complications
10:41 – Managing the "Smoldering" Anxiety
11:27 – Acknowledgments & Conclusion
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