Chronic myeloid leukaemia

= CML

  • Philadelphia chromosome
    • refers to translocation - t(9:22)(q34; q11)
    • results in BCR-ABL gene fusion → ↑ tyrosine kinase activity
  • can transform to higher grade malignancy i.e. acute myeloid leukaemia
  • mainly affects adults, 90% 5-year survival

clinical presentation

  • ↑ metabolism
  • splenomegaly
  • abnormal platelet function:
  • ↑ uric acid
  • blast transformation

investigations

FBC findings

  • basophilic leukocytosis
  • normochromic normocytic anaemia
  • thrombocytosis

bone marrow

hypercellular with granulopoietic predominance

management

  • imitanib
    • tyrosine kinase inhibitor
  • interferon-alpha

high risk of Tumour lysis syndrome

#oncology #haematology