Haematology 7 - CML Flashcards
How does CML affect the liver and spleen?
Infarction of cords and red pulp (spleen) and hepatic sinusoids (liver) by granulocytes- causes hepatosplenomegaly, but no lymphadenopathy in CML
Recall 3 possible symptoms of CML
Lethargy
Bruising
Monocular blindness (due to CVA)
In what ways will a blood film be unusual in CML?
Myelocytes present (precursor neutrophils) Raised basophils, eosinophiles
What investigation can be done to show BCR-ABL
FISH - a fluorescent DNA probe hybridises selectively to a particular chromosome segment
PCR (best to diagnose and determine response to therapy)
What are the phases of CML?
Chronic: 3-4 years (<5% blasts in BM)
Accelerated: 6-12 months (5-19% blasts)
Blast crisis: 3-6 months (>20% blasts)
What are the 1st, 2nd and 3rd line treatments for CML?
1st. Imatinib (1st gen Abl-TK inhibitor)
2nd. 2nd/3rd generation TK inhibitor
3rd. allogenic stem cell transplant