Chronic myeloid leukaemia

Question 1

What is the genetic features

Answer 1

Balanced translocation

Philadelphia chromosome

Question 2

What 2 chromosomes are involved in the balanced translocation

Answer 2

9

22

Question 3

Management

Answer 3

Targeted therapy with tyrosine kinase inhibitors

- imatinib

Question 4

There is high failure rate of management. True or false?

Answer 4

False

- very successful treatment

Question 5

There is presence of lots of immature cells. True or false?

Answer 5

False

- cells go through the maturation process but there are too many of them

Question 6

Maturation is preserved. True or false?

Answer 6

True

Question 7

There is too many white cells. True or false?

Answer 7

True

WCC can be up to 300-400

Question 8

Definition

Answer 8

Proliferation of myeloid ells

• granulocytes and their precursors
• other lineages (platelets)

Question 9

Blood film shows immature/mature neutrophils in the blood?

Answer 9

Mature

Question 10

Clinical features

Answer 10

Asymptomatic
Splenomegaly
Hypermetabolic symptoms - night sweats, weight loss, fever, early satiety
Gout

Question 11

Blood count changes

Answer 11

Normal or low Hb 
Leucocytosis (increased WBC)
- neutrophilia 
- myeloid precursors (myelocytes)
- eosinophilia 
- basophilia 
Thrombocytosis (increased platelets)

Question 12

How do you diagnose this?

Answer 12

Presence of the philadelphia chromosome

Question 13

What is the hallmark of CML

Answer 13

Philadelphia chromosome

Question 14

CML is BCR-ABL1 negative or BCR-ABL1 positive ?

Answer 14

BCR-ABL1 positive

Question 15

CML is the paradigm for targeted therapies in oncology. How so?

Answer 15

Works well with CML as it is only 1 mutation which is known