Chronic Myeloid Leukemia
Definition
Clonal disorder of a pluripotent stem cell.
Signs & Symptoms
Weight loss, anorexia/night sweats, splenomegaly, pallor, dyspnea and tachycardia. Bruising, epistaxis, menorrhagia, gout or renal impairment.
Risk Factors
Most common between 40 – 60 years old.
Causes
Ph chromosome t(9;22), BCR-ABL gene.
Peripheral blood characteristics
Leucocytosis, complete spectrum of myeloid cells seen. Normochromic, normocytic anemia. Platelet count may be increased (most common), normal or decreased.
Bone Marrow characteristics
Hypercellular with granulopoietic predominance.
Important investigations & related results
Ph chromosome in FISH cytogenetic analysis. Increased serum uric acid. Low NAP score.
Treatment & management
Tyrosine kinase inhibitors – Imatinib (Glivec)
: Chemotherapy – hydroxyurea
: α- interferon
: stem cell transplantation
Peripheral blood smear of CML x 400.
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