Chronic myeloid leukemia: Difference between revisions
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*Triphasic: chronic phase, accelerated phase, and blast crisis |
*Triphasic: chronic phase, accelerated phase, and blast crisis |
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| − | *Almost half are asymptomatic on diagnosis |
+ | *Almost half are asymptomatic on diagnosis, found by abnormalities on routine bloodwork |
*Presenting complaints may include fatigue, weight loss, sweating, abdominal fullness, and bleeding |
*Presenting complaints may include fatigue, weight loss, sweating, abdominal fullness, and bleeding |
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*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 |
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*Can present with anemia, very elevated WBCs, and elevated platelets |
*Can present with anemia, very elevated WBCs, and elevated platelets |
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| + | *Can precipitate [[gout]] |
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| + | *Extramedullary findings are usually limited to blast crisis, and would include lymphadenopathy, skin findings, and soft tissue findings |
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===Prognosis and Complications=== |
===Prognosis and Complications=== |
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Latest revision as of 10:34, 20 February 2022
Clinical Manifestations
- Triphasic: chronic phase, accelerated phase, and blast crisis
- Almost half are asymptomatic on diagnosis, found by abnormalities on routine bloodwork
- 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
- Can precipitate gout
- Extramedullary findings are usually limited to blast crisis, and would include lymphadenopathy, skin findings, and soft tissue findings
Prognosis and Complications
- Outcomes are very good since the introduction of tyrosine kinase inhibitors
- Prognostic models exist, including Sokal score, 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
