الفهرس 
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Abstract
The most common form of adult human leukemia is chronic lymphocytic leukemia
(CLL), which can be either aggressive or slow-growing, both characterized by an
overabundance of clonal B cells infiltrating the blood circulation, bone marrow along with
lymph nodes. CLL is a disease with a varied prognosis; whereas the majority of patients
experience an indolent course for many years, some cases advance quickly and demand
early intervention. Up to 10% of CLL patients eventually develop a more severe form of B
cell lymphoma (Richter’s syndrome), which has a markedly worse prognosis (Delgado et
al., 2020).
Prognostic indicators can be used to classify CLL patients into different risk groups,
such as the expression of cluster of differentiation 38 (CD38), 70 kD zeta-associated protein
(ZAP70) and unmutated immunoglobulin heavy variable genes (UM-IgVH) mutations.
Cytogenetic changes at two loci encompassing the p53 gene (17p deletion) and the Ataxia
Telangiectasia Mutated (ATM) gene (11q deletion) were linked to a worse prognosis, shortened
remission duration and reduced lifespan, whereas the normal karyotype or 13q14 deletion
were considered low risk, while trisomy 12 is considered intermediate risk (Grenda et al.,
2022).