Chronic myeloid leukaemia (CML)
Last updated: Tuesday, 23, November, 2010
Chronic myeloid (granulocytic) leukaemia (CML) is one of the myeloproliferative disorders (clonal stem cell disorders) in which excessive granulocyte production is the dominant feature.
FBC (neutrophilia with early myeloid cells; basophilia ± eosinophilia; thrombocytosis); bone marrow aspiration and trephine biopsy with cytogenetics (oncology) (Philadelphia chromosome) and molecular genetics (bcr-abl fusion gene).
Neutrophil alkaline phosphatase (low) is now only occasionally performed.See also Chronic leukaemia
|Urate - plasma or serum.|
The natural history of CML is triphasic:
• a chronic phase lasting a median of 4-6 years
• an accelerated phase lasting months during which constitutional symptoms increase and the haematological parameters become increasingly unstable
• a blastic phase resembling an acute leukaemia which has a very poor response rate to chemotherapy.
Allogeneic stem cell transplantation is the only modality known to be curative. The recently available drug Glivec (imatinib) produces cytogenetic and molecular remissions in many patients and appears to improve survival.