Chronic myeloid leukemia: Difference between revisions

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== Clinical Manifestations ==
==Clinical Manifestations==


* Triphasic: chronic phase, accelerated phase, and blast crisis
*Triphasic: chronic phase, accelerated phase, and blast crisis
* Almost half are asymptomatic on diagnosis
*Almost half are asymptomatic on diagnosis
* Prsenting complaints may include fatigue, weight loss, sweating, abdominal fullness, and bleeding
*Presenting complaints may include fatigue, weight loss, sweating, abdominal fullness, and bleeding
* Often have splenomegaly, which can contribute to the abdominal fullness and cause LUQ or left shoulder pain
*Often have [[splenomegaly]], which can contribute to the abdominal fullness and cause LUQ or left shoulder pain
* Can present with anemia, very elevated WBCs, and elevated platelets
*Can present with anemia, very elevated WBCs, and elevated platelets

=== Prognosis and Complications ===

* Outcomes are very good since the introduction of tyrosine kinase inhibitors
* Prognostic models exist, including Sokal, Euro (Hasford), EUTOS, and ELTS scores

== Differential Diagnosis ==

* [[Leukemoid reaction]]
* [[Juvenile myelomonocytic leukemia]]
* [[Chronic myelomonocytic leukemia]]
* [[Chronic eosinophilic leukemia]]
* [[Chronic neutrophilic leukemia]]

== Diagnosis ==

* Usually suspected in asymptomatic patient with typical findings in peripheral blood or bone marrow
* Confirmed with detection of BCR-ABL1 fusion gene in peripheral blood or bone marrow

== Management ==

* Can use empiric [[hydroxyurea]] for cytoreduction while awaiting diagnosis if WBC >80


[[Category:Hematology]]
[[Category:Hematology]]

Revision as of 21:02, 26 February 2021

Clinical Manifestations

  • Triphasic: chronic phase, accelerated phase, and blast crisis
  • Almost half are asymptomatic on diagnosis
  • Presenting complaints may include fatigue, weight loss, sweating, abdominal fullness, and bleeding
  • Often have splenomegaly, which can contribute to the abdominal fullness and cause LUQ or left shoulder pain
  • Can present with anemia, very elevated WBCs, and elevated platelets

Prognosis and Complications

  • Outcomes are very good since the introduction of tyrosine kinase inhibitors
  • Prognostic models exist, including Sokal, Euro (Hasford), EUTOS, and ELTS scores

Differential Diagnosis

Diagnosis

  • Usually suspected in asymptomatic patient with typical findings in peripheral blood or bone marrow
  • Confirmed with detection of BCR-ABL1 fusion gene in peripheral blood or bone marrow

Management

  • Can use empiric hydroxyurea for cytoreduction while awaiting diagnosis if WBC >80