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. 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===
==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===
==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===
==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===
==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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