Haematology - CML

Question 1

How does CML affect the liver and spleen?

Answer 1

Infarction of cords of Billroth/red pulp (spleen) and hepatic sinusoids (liver) by granulocytes

Question 2

Recall 3 possible symptoms of CML

Answer 2

Lethargy
Bruising
Monocular blindness (due to CVA)

Question 3

In what ways will a blood film be unusual in CML?

Answer 3

Biphasic peak of neutrophils and myelocytes
Raised basophils

Question 4

What investigation can be done to show BCR-ABL

Answer 4

FISH - a fluorescent DNA probe hybridises selectively to a particular chromosome segment

Question 5

What are the phases of CML?

Answer 5

Chronic: 3-4 years (less than 5% blasts)
Accelerated: 6-12 months (over 10% blasts)
Blast crisis: 3-6 months (over 20% blasts)

Question 6

What are the 1st line treatments for CML?

Answer 6

1st. Imatinib (BCR ABL TKI)

Question 7

what’s a main finding o/e in CML

Answer 7

massive splenomegaly

Question 8

what fusion gene in CML

Answer 8

BCR ABL philadelphia