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Haematology > CML > Flashcards

CML Flashcards

1
Q

What is the average age of presentation in CML?

A

45-55 yo

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2
Q

What percentage of Adult Leukemias?

A

15%

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3
Q

What percentage is diagnosed via routine lab tests?

A

50%

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4
Q

What percentage is dignosed in the chronic phase?

A

85%

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5
Q

What are causes of CML?

A
  1. Idiopathic
  2. Radiation Exposure
  3. Chemical Exposure
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6
Q

What factors play a role in incidence of CML?

A
  1. Dose

2. Time of exposure

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7
Q

What are important lab findings in CML?

A
  1. Elevated Uric Acid
  2. Low LAP score (Benign granulocytes would have normal LAP score)
  3. Elevated B12 levels
  4. B12 Binding Protein elevation Transcobalamine 1
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8
Q

What is the terminal event in CML?

A

Blast crisis

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9
Q

What percentage transforms to AML?

A

2/3

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10
Q

What percentage transforms to ALL?

A

1/3

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11
Q

What is characteristic of CML?

A

Basophilia

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12
Q

What is the mutation in CML?

A

t(9;22) Philadelphia Chromosome

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13
Q

What does this translocation result in?

A

BCR-ABL fusion protein which results in increased tyrosine kinase activity.

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14
Q

What is the first line treatment for CML?

A

Imatinib TK inhibitor

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15
Q

What is the most prominent physical finding?

A

Splenomegaly sometimes due to metastasis

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16
Q

What percentage of CML patients show the t(9;22) translocation?

A

95%

17
Q

Philadelphia Chromosome is present in

what percentage of RBC, WBC, Monocytes and platelets?

A

100%

18
Q

What is the only known cure for CML?

A

Bone Marrow transplant.

19
Q

What does imatinib effectively do?

A

Blocks the ATP binding site in the BCR-ABL fusion protein. Stopping the activity and generation of Tyrosine Kinase.

20
Q

What is the bioavailability of Imatinib?

A

98%

21
Q

What are the agents used in cases of Imatinab resistance?

A

Dasatinib & Nilotinib

22
Q

What feature in PB smear is present only in CML?

A

Thrombocytosis.

Haematology (16 decks)

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