Chronic myeloid leukaemia

Question 1

What causes CML?

Answer 1

95% due to t(9:22) translocation- Philadelphia chromosome. BCR-ABL gene fusion causes enzyme with abnormal tyrosine kinase activity -> excessive proliferation.

Question 2

CML- who gets CML?

Answer 2

Often caught by chance on a routine FBC in elderly people >65.

Question 3

CML- blood results

Answer 3

Normocytic anaemia.
Leucocytosis. WBC raised > 50/ >500.
Thrombocytopenia if in blast crisis- can transform to AML.

Question 4

CML- symptoms

Answer 4

B symptoms- weight loss, night sweats, fever.
Splenomegaly.
High WBC -> viscous blood -> clots.

Question 5

CML- treatment

Answer 5

Tyrosine kinase inhibitor- Imatinib. Prevents ATP binding to BRC-ABL. Well tolerated, taken for decades.

Allogenic bone marrow transplant.