**6. Chronic lymphocytic leukemia (CLL)**

Chronic lymphocytic leukemia (chronic lymphoid leukemia CLL), is a heterogeneous disease characterized by the proliferation of functionally incompetent in the peripheral blood, bone marrow, spleen and lymph nodes. CLL is a disease of adult the elder age group as with a median onset at initial diagnosis of 70 and 75 years old and the male to female ratio 2:1 [47].

#### **6.1 Treatment of chronic lymphoyctic leukemia**

The CLL disease extent and prognosis according to Rai and Binet staging systems. Early stages (0, I, II) and symptomatic patient keep for observation and regular follow up without treatment. 70% of CLL patients respond to chlorambucil monotherapy which may be given orally for stabilization of leukocytosis and symptoms. Thrombocytopenia in stage IV stabilized with addition of prednisone.
