CML

• Clonal proliferation of multipotential stem cells; no block in maturation

• Seen in people 25-60 YOA, slightly more in males

• 15-20% of all cases of leukemia

• Insidious onset and vague C/S

• WBC often > 100,000/mm³

  • Circulating cells are mostly neutrophils and metamyelocytes, but less mature neutrophilic precursors may be present, including a small number of myeloblasts, and some nucleated RBCs (leukoerythroblastosis)

  • Since it is a stem cell disease, eosinophilia, basophilia, and thrombocytosis may be seen

• Blast crisis

  • Accelerated phase with development of resistance to therapy, development of anemia and/or thrombocytopenia, acquisition of more chromosomal abnormalities, and may even begin to look like an acute leukemia

    • 70% of patients have leukemic blasts with myeloid features

    • Blasts in other 30% are lymphoid origin

  • Pretty much all treatments (save Gleevec) are worthless

Category: Medical Subject Notes , Pathology Notes