Hematologic Malignancies Leukemias

Question 1

Chronic Myeloid Leukemia (CML)

• Median age of diagnosis: 66
• More common in ___ (2.5 vs. 1.5)
• 5-year relative survival: 70%

Answer 1

men

Question 2

CML – Pathophysiology

Unregulated myeloid proliferation = excess mature neutrophil production
- oncogenic protein resulting in the pathogenesis of CML = ___ chromosome
- Present in 95% of patients with CML
- Constitutively active tyrosine kinase
- Increased proliferation of the CML clone
- Decreased apoptosis

Question 3

CML – Philadelphia chromosome

• Shortened long arm on chromosome __
• Found in granulocyte and erythrocyte progenitors, macrophages, megakaryocytes,
  and lymphocytes

Breaks in chromosome 9 & 22 = translocate to form BCR-ABL fusion gene
- ABL (proto-oncogene) on 9
- BCR on 22

___ active oncogene

Question 4

CML – Risk Factors

• No genetic component identified
• Ionizing radiation
• Atomic bomb survivors

Question 5

CML – Presentation

• fatigue
• sweating
• bone pain
• weight loss
• abdominal discomfort
• splenomegaly = early satiety

Question 6

CML – Diagnosis

CBC with differential and CMP with uric acid

Bone marrow biopsy required
- Hypercellular
- Granulocyte/erythroid ratio increased
- Fluorescence in situ hybridization (FISH) to assess Ph chromosome
- PCR to assess BCR-ABL transcript baseline levels
- Monitored on the International Scale (IS)
- Follow during CML treatmen