Chronic Myeloid Leukaemia

Question 1

Genetic component of CML

Answer 1

Philadelphia Chromosome
t(9:22)

ABL proto-oncogene from chromosome 9 being fused with the BCR gene from chromosome 22.

BCR-ABL gene codes for a fusion protein that has excess tyrosine kinase activity

Question 2

At what age do patients normally present with CML?

Answer 2

60-70years

Question 3

How do patients normally present with CML

Answer 3

• anaemia: lethargy
• weight loss and sweating
• splenomegaly

Question 4

Patient with CML may undergo blast transformation. What cancer do they develop as a result?

Answer 4

AML in 80%
ALL in 20%

Question 5

Management of CML

Answer 5

imatinib = 1st Line
- Tyorsine Kinase inhibitor

Others:
hydroxyurea
interferon-alpha
allogenic transplant