Chronic Myeloid Leukemia (CML)

Author: owner     Published: 2 years ago 2 Replies

What are the stages of CML (Chronic Myeloid leukemia)?

There are 3 stages of CML.

  1. Chronic phase,
  2. Accelerated phase &
  3. Blast phase.

CHRONIC PHASE:

  • It is characterized by less than 10% blast cells in blood & bone marrow.
  • Wbc capable of fighting infections.

ACCELERATED PHASE:

  • 10-19% blast cells in blood & bone marrow.
  • High basophil count >20% of wbcs.
  • Persistent thrombocytopenia unrelated to therapy.
  • Persistent thrombocytosis.
  • Increasing wbcs & spleen unresponsive to therapy.
  • There is fever, poor appetite & weight loss.

BLAST CRISIS:

  • > 25% blast cells in blood & bone marrow.
  • There is fever, loss of apetite, weight loss, fatigue, bleeding, infections common, bone pain. 
Maryum batool, 2 years ago

PARTIAL HEMATOLOGICAL REMISSION IN CML is defined as:

  • Wbc count <10000.
  • Platelet count <50% of pretreatment count  but greater than 450000.
  • Persistent splenomegaly but <50%of pretreatment extent.

COMPLETE HEMATOLOGICAL REMISSION:

  • WBCS <10000.
  • Platelat count <450000.
  • No immature cells such as blasts, promyelocytes & metamyelocytes.
  • Disapperance of palpable spleen.

CYTOGENETIC REMISSION:

  • normal chromosomes return with 0% Philadelphia chromosomes. This is detected by karyotyping or FISH technique.
  • Major cytogenetic response:0-35%
  •  Ph chromosomes.

Minor cytogenetic response:

  • 1-34% Philadelphia positive chromosomes.

MOLECULAR RESPONSE: 

  • there should be negative PCR results for BCR/ABL mRNA. Detected by measuring quantitave pcr.

Complete molecular response:

  • BCR-abl mRNa undetected by PCR.

Major molecular response:

  • > 3 log reduction of bcr-abl mRNA which should be acheived within 12 months. 
Maryum batool, 2 years ago

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