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Chronic myeloid leukaemia (CML) is a type of [[myeloproliferative neoplasm,]] [[AKA]] ''chronic myelogenous leukemia''. It is driven by the bcr-abl fusion protein, detectable cytogenetically as the Philadelphia chromosome. It is a [[leukemia]] in that the fusion protein drives granulopoiesis (and less commonly megakaryopoiesis), resulting in marked peripheral blood leucocytosis. | Chronic myeloid leukaemia (CML) is a type of [[myeloproliferative neoplasm,]] [[AKA]] ''chronic myelogenous leukemia''. It is driven by the bcr-abl fusion protein, detectable cytogenetically as the Philadelphia chromosome. It is a [[leukemia]] in that the fusion protein drives granulopoiesis (and less commonly megakaryopoiesis), resulting in marked peripheral blood leucocytosis. | ||
==General== | |||
*Adults - usu. 50s or 60s. | *Adults - usu. 50s or 60s. | ||
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*Myeloblast (common granulocyte precursor) -> promyelocyte -> metamyelocyte -> myelocyte -> band -> mature myelocyte.<ref name=hemechart>URL: [http://commons.wikimedia.org/wiki/File:Hematopoiesis_%28human%29_diagram.png http://commons.wikimedia.org/wiki/File:Hematopoiesis_%28human%29_diagram.png]. Accessed on: 14 January 2012.</ref> | *Myeloblast (common granulocyte precursor) -> promyelocyte -> metamyelocyte -> myelocyte -> band -> mature myelocyte.<ref name=hemechart>URL: [http://commons.wikimedia.org/wiki/File:Hematopoiesis_%28human%29_diagram.png http://commons.wikimedia.org/wiki/File:Hematopoiesis_%28human%29_diagram.png]. Accessed on: 14 January 2012.</ref> | ||
==Microscopic== | |||
Features: | Features: | ||
*Bone marrow with too many granulocytes/granulocyte precursors. | *Bone marrow with too many granulocytes/granulocyte precursors. | ||
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**#Band - dia. 1x mature, 30-40% nucleus - C shape/irregular, no nucleolus. | **#Band - dia. 1x mature, 30-40% nucleus - C shape/irregular, no nucleolus. | ||
==IHC== | |||
Rarely required. CML may transform into a blast phase, typically myeloid blasts, but lymphoblasts may also be seen. These blasts are typically CD34 and/or CD117 positive. The myeloid blasts will express myeloid markers and the lymphoblasts will shows lymphoid markers. | Rarely required. CML may transform into a blast phase, typically myeloid blasts, but lymphoblasts may also be seen. These blasts are typically CD34 and/or CD117 positive. The myeloid blasts will express myeloid markers and the lymphoblasts will shows lymphoid markers. | ||
==Molecular== | |||
*t(9;22) BCR-ABL - '''required for diagnosis'''. | *t(9;22) BCR-ABL - '''required for diagnosis'''. | ||
**May be found in other leukemias. | **May be found in other leukemias. | ||
==See also== | |||
*[[Leukemia]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category: Hematopathology]] | [[Category: Hematopathology]] |
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