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instit.oncol.cluj-napoca- sectia hematologie - 2012

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1. Analiza moleculara – statusul mutational al portiunii variabile a genei pentru lanturile<br />

grele ale imunoglobulinelor (IgHV)<br />

2. Imagistica : Rx (torace, osos), CT, RMN, ecografie – in caz de boala bulky<br />

neevidentiabila clinic, suspiciune infiltrat SNC, suspiciune infectii, etc<br />

3. Beta-2-microglobulina<br />

4. Biopsia osteo-medulara, medulograma<br />

5. Anticorpi anti-trombocitari – in caz de suspicine de trombocitopenie autoimuna<br />

6. Biopsie ganglionara – in special in caz de suspiciune sindrom Richter<br />

7. Bacteriologie, virusologie – in functie de evolutia clinica, in caz de suspiciune de<br />

infectii – vezi protocol neutropenii febrile<br />

8. Markeri tumorali specifici, biopsie tumora – in caz de suspiciune a unei a doua<br />

neoplazii<br />

9.3 STADIALIZARE, FACTORI DE PROGNOSTIC.<br />

9.3.1. Stadializare. Se folosesc 2 sisteme de stadializare, cele definite de Rai si respectiv Binet.<br />

1. Stadializarea Rai<br />

- Stadiul 0<br />

- limfocitoza periferica >5000/µl<br />

- limfocitoza medulara >40%<br />

- Stadiul I<br />

- stadiul 0 + hepato si/sau splenomegalie, ± adenopatii<br />

- Stadiul III<br />

- stadiul 0 + anemie (Hb

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