Chronic Myeloid Leukaemia

Question 1

What is CML?

Answer 1

Chronic myeloid leukaemia

Neoplastic proliferation of mature myeloid cells (granulocytes)

Question 2

What are risk factors for CML?

Answer 2

Age (older)

Radiation

Question 3

What translocation is associated with CML?

Answer 3

t(9;22)

Philadelphia chromosome

Question 4

What investigations are done for suspected CML?

Answer 4

FBC
Blood film
Bone marrow biopsy

Question 5

What does the FBC show in CML?

Answer 5

Leucocytosis
Thrombocytosis/thrombocytopenia
Anaemia

Raised granulocyte count

Question 6

What does the blood film show in CML?

Answer 6

Increased number of mature granulocytes

Question 7

What does the bone marrow biopsy show in CML?

Answer 7

Increased number of mature granulocytes

Question 8

How is CML managed?

Answer 8

Imatinib

- tyrosine kinase inhibitor

Question 9

What are the phases of CML?

Answer 9

Chronic
Accelerated
Blast

Question 10

What happens in the chronic phase of CML?

Answer 10

Asymptomatic

Raised WCC

Question 11

What happens in the accelerated phase of CML?

Answer 11

Abnormal blast cells 10-20%

Symptomatic

Question 12

What happens in the blast phase?

Answer 12

Blast cells >30%

Pancytopenia