Chronic Myeloid Leukaemia

Question 1

Define CML

Answer 1

Uncontrolled clonal proliferation of myeloid cells

Question 2

What type of disorder is CML?

Answer 2

Myeloproliferative

Question 3

Who is most likely to develop CML?

Answer 3

40-60 year olds

Question 4

How many patient’s with CML have the Philadelphia chromosome?

Answer 4

> 80%

Question 5

What is the Philadelphia chromosome?

Answer 5

A hybrid chromosome due to a translocation of the q arms of chromosomes 9 and 22

Question 6

What are some symptoms of CML?

Answer 6

Wt loss, tiredness, fever, sweats, gout, bleeding, abdominal discomfort, anaemia, infection

Question 7

What are some signs of CML?

Answer 7

Massive hepatosplenomegaly

Question 8

What would you expect the WCC result to be?

Answer 8

Very high

Question 9

What would a blood film show?

Answer 9

An increase in whole spectrum of myeloid cells (neutrophils, monocytes, eosinophils, basophils)

Question 10

What would you expect to happen to urate and B12?

Answer 10

Increase

Question 11

What would you see in the bone marrow?

Answer 11

Hypercellular

Question 12

What is the main drug that inhibits tyrosine kinase, the enzyme produced by Ph?

Answer 12

Imatinib

Question 13

What are the three phases of CML?

Answer 13

Chronic, Accelerated, Blast transformation

Question 14

How would you manage CML?

Answer 14

Chemo, tyrosine kinase inhibitors, stem cell transplant