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Difference between revisions of "Chronic myeloid leukemia"
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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. | |||
[[Category: | ===General=== | ||
*Adults - usu. 50s or 60s. | |||
Clinical - commonly:<ref>{{Ref PCPBoD8|336}}</ref> | |||
*Leukocytosis - neutrophils, myelocytes, metamyelocytes, +/-eosinophilia, +/-basophilia. | |||
Progression: | |||
#Chronic phase - potentially curable. | |||
#Accelerated phase. | |||
#Blast crisis. | |||
Treatment: | |||
*[[Imatinib]] and other [[tyrosine kinase inhibitors]] | |||
Notes: | |||
*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: | |||
*Bone marrow with too many granulocytes/granulocyte precursors. | |||
**Granulocyte precursors:<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) ~ 90% nucleus, multiple nucleoli. | |||
**#*Should be less than 10%. | |||
**#Promyelocyte (committed to a specific linage ([[neutrophil]], basophil or [[eosinophil]])) - dia. 2x mature, 40-50% nucleus, one [[nucleolus]]. | |||
**#Metamyelocyte - dia. 2x mature, 30-40% nucleus, no nucleolus. | |||
**#Myelocyte - dia. 1x mature, 50-60% nucleus - kidney bean shape, no nucleolus. | |||
**#Band - dia. 1x mature, 30-40% nucleus - C shape/irregular, no nucleolus. | |||
===IHC=== | |||
Features:<ref>{{Cite journal | last1 = Muñoz | first1 = L. | last2 = Bellido | first2 = M. | last3 = Sierra | first3 = J. | last4 = Nomdedéu | first4 = JF. | title = Flow cytometric detection of B cell abnormal maturation in chronic myeloid leukemia. | journal = Leukemia | volume = 14 | issue = 2 | pages = 339-40 | month = Feb | year = 2000 | doi = | PMID = 10673756 |URL = http://www.nature.com/leu/journal/v14/n2/full/2401549a.html }}</ref> (???) | |||
*Chronic: | |||
**CD20+ CD19+ CD10-. | |||
*Accelerated: | |||
**CD20+ CD19+ CD10+. | |||
*Blast: | |||
**CD20- CD19+ CD10+. | |||
**CD34+ TdT+.<ref>URL: [http://path.upmc.edu/cases/case271.html http://path.upmc.edu/cases/case271.html]. Accessed on: 14 January 2012.</ref> | |||
===Molecular=== | |||
*t(9;22) BCR-ABL - '''required for diagnosis'''. | |||
**May be found in other leukemias. | |||
[[Category: Hematopathology]] | |||