Chronic myeloid leukemia

(Redirected from CML)

Background

  • Also known as chronic myelogenous leukemia, chronic myelocytic leukemia
  • More common in older patients

Clinical Features

Usually progresses through 3 stages

Chronic phase

Accelerated phase

Blast crisis

Differential Diagnosis

Oncologic Emergencies

Related to Local Tumor Effects

Related to Biochemical Derangement

Related to Hematologic Derangement

Related to Therapy

Leukocytosis

Evaluation

  • CBC
    • Leukocytosis: usually only moderately elevated in chronic phase (20,000-60,000)
    • Mild-moderate anemia
    • Variable platelet counts
  • Peripheral smear
  • DIC labs: coags, d-dimer, fibrinogen
  • Tumor lysis syndrome labs: BMP, uric acid, phosphate
  • Infectious workup
  • Evaluate for complications

Management

Disposition

  • Can consider discharging asymptomatic patients in chronic phase who have no complications and close follow-up. Otherwise, admit.

See Also

External Links

References