Chronic myelogenous leukemia staging
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]
Overview
Chronic myelogenous leukemia may be classified according to the clinical characteristics and laboratory findings into five phases: chronic phase, accelerated phase, blast crisis, relapsed or recurrent CML and refractory disease. The earliest phase is the chronic phase and generally has the best response to treatment. The accelerated phase is a transitional phase and blastic phase is a aggressive phase that becomes life-threatening. Relapsed CML means that the number of blast cells in the blood and bone marrow increase after remission and finally, refractory disease means the leukemia did not respond to treatment.[1][2]
Classification
Chronic myelogenous leukemia is often divided into five phases based on clinical characteristics and laboratory findings.[3]
- Chronic. The chronic phase is the earliest phase and generally has the best response to treatment.
- Chronic phase (CP), if left untreated advances to an accelerated phase (AP) after three to five years.
- Leukocytosis of more than 100 000/µL with continuous left shift leading to myeloblasts or promyelocytes is a characteristic of the chronic phase.
- Splenomegaly is a characteristic of the chronic phase.
- Accelerated. The accelerated phase is a transitional phase when the disease becomes more aggressive.
- Increased numbers of blast cells in the blood or bone marrow
- Increased or decreased platelet count
- Increased numbers of basophil cells in the peripheral blood
- Other chromosome abnormalities (e8)
- Blastic. Blastic phase is a severe, aggressive phase that becomes life-threatening.
- increased blast cell numbers in the blood or bone marrow, matches the clinical picture of acute leukemia
- Relapsed CML. Relapsed, or recurrent CML means that the number of blast cells in the blood and bone marrow increase after treatment.
- Refractory disease. It means the leukemia did not respond to treatment.
References
- ↑ von Bubnoff N, Duyster J (February 2010). "Chronic myelogenous leukemia: treatment and monitoring". Dtsch Arztebl Int. 107 (7): 114–21. doi:10.3238/arztebl.2010.0114. PMC 2835925. PMID 20221270.
- ↑ Jabbour E, Kantarjian H (May 2014). "Chronic myeloid leukemia: 2014 update on diagnosis, monitoring, and management". Am. J. Hematol. 89 (5): 547–56. doi:10.1002/ajh.23691. PMID 24729196.
- ↑ Canadian Cancer Society.2015.http://www.cancer.ca/en/cancer-information/cancer-type/leukemia-chronic-myelogenous-cml/staging/?region=ab