Chronic myeloid leukemia

Revision as of 05:56, 24 September 2016 by Rossdonaldson1 (talk | contribs) (Differential Diagnosis)

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