Difference between revisions of "Chronic myeloid leukemia"

(Differential Diagnosis)
(Clinical Features)
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==Clinical Features==
 
==Clinical Features==
*Usually progresses through 3 stages:
+
''Usually progresses through 3 stages''
*Chronic phase
+
 
**Asymptomatic or indolent, nonspecific symptoms
+
===Chronic phase===
**Malaise, fatigue, weight loss, low grade fever
+
*Asymptomatic or indolent, nonspecific symptoms
**Lymphadenopathy, splenomegaly
+
*Malaise, fatigue, weight loss, low grade fever
*Accelerated phase
+
*Lymphadenopathy, splenomegaly
**Worsening of above symptoms due to progressive leukocytosis
+
 
**Signs/symptoms of [[thrombocytopenia]] (e.g. petechiae, bleeding) or thrombocytosis
+
===Accelerated phase===
*Blast crisis
+
*Worsening of above symptoms due to progressive leukocytosis
**Behaves like [[acute leukemia]]
+
*Signs/symptoms of [[thrombocytopenia]] (e.g. petechiae, bleeding) or thrombocytosis
**Associated with [[Leukostasis and hyperleukocytosis]] and [[Hyperviscosity syndrome]]
+
 
 +
===Blast crisis===
 +
*Behaves like [[acute leukemia]]
 +
*Associated with [[Leukostasis and hyperleukocytosis]] and [[Hyperviscosity syndrome]]
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==

Revision as of 06:07, 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

Differential Diagnosis

Oncologic Emergencies

Related to Local Tumor Effects

Related to Biochemical Derangement

Related to Hematologic Derangement

Related to Therapy

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

Disposition

See Also

External Links

References