chronic%20myeloid%20leukemia
CHRONIC MYELOID LEUKEMIA

Chronic myelogenous leukemia (CML) is a malignant myeloid disorder characterized by the presence of a distinctive cytogenetic abnormality known as the Philadelphia chromosome.

Exposure to ionizing radiation is the only known risk factor with median presentation at age >50 years old.

Three phases of the disorder are chronic, accelerated and blast.

Choice of therapy is influenced by age, availability of a donor, comorbidities and phase of CML.

Introduction

  • Also known as chronic myelogenous, myelocytic, or chronic granulocytic leukemia
  • Has three phases: chronic, accelerated & blast
  • Median age at presentation is at >50 years old

Definition

  • A myeloid disorder associated with Philadelphia (Ph) chromosome t(9;22)(q34;q11), a fusion of the breakpoint cluster region (BCR) & Abelson murine leukemia (ABL1) genes

Signs and Symptoms

  • Systemic symptoms:
    • Anemia
    • Abdominal fullness
    • Abdominal pain that may present with left upper quadrant pain & early satiety
    • Bleeding episodes due to platelet dysfunction
    • Fatigue
    • Malaise
    • Weight loss
  • Other frequent findings:
    • Splenomegaly
    • Platelet count raised
    • White blood cell (WBC) count increased
    • Involvement of lymph nodes, skin & soft tissue (patients with blast crisis)

Risk Factors

  • The only known risk factor is exposure to ionizing radiation
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