Chronic myeloid leukemia

Background

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

Clinical Features

Usually progresses through 3 stages

Chronic phase

  • Asymptomatic or indolent, nonspecific symptoms
  • Malaise, fatigue, weight loss, low grade fever
  • Lymphadenopathy, splenomegaly

Accelerated phase

  • Worsening of above symptoms due to progressive leukocytosis
  • Signs/symptoms of thrombocytopenia (e.g. petechiae, bleeding) or thrombocytosis

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

See Also

External Links

References