Chronic myeloid leukemia: Difference between revisions
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Revision as of 05:55, 24 September 2016
Background
- aka chronic myelogenous leukemia, chronic myelocytic leukemia
- More common in older patients
Clinical Features
- Usually progresses through 3 stages:
- Chronic phase
- Asymptomatic or indolent, nonspecific symptoms
- Malaise, fatigue, weight loss, low grade fever
- Lymphadenopathy, splenomegaly
- Accelerated phase
- Worsening of above symptoms due to progressive leukocytosis
- Signs/symptoms of thrombocytopenia (e.g. petechiae, bleeding) or thrombocytosis
- Blast crisis
- Behaves like acute leukemia
- Associated with Leukostasis and hyperleukocytosis and Hyperviscosity syndrome
Differential Diagnosis
Evaluation
- CBC-
- Leukocytosis: usually only moderately elevated in chronic phase (20,000-60,000)
- Mild-moderate anemia
- Variable platelet counts
- Peripheral smear
- DIC labs: coags, d-dimer, fibrinogen
- Tumor lysis syndrome labs: BMP, uric acid, phosphate
- Infectious workup
- Evaluate for complications
Management
- See management of Leukostasis and hyperleukocytosis, neutropenic fever, hyperviscosity syndrome, tumor lysis syndrome, thrombocytopenia