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Leukemia, Chronic Myelogenous

Jan Cerny, MD, PhD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Chronic myelogenous leukemia (CML) is a myeloproliferative neoplasm characterized by clonal proliferation of myeloid precursors in the bone marrow with continuing differentiation int...

DIAGNOSIS

85–90% of patients present in the chronic phase, and the disease can be found accidentally during routine screening. 

HISTORY

  • Chronic phase: fatigue, weight loss, night sweats, abdominal fulln...

TREATMENT

MEDICATION

  • TKIs (e.g., imatinib) provide durable, long-term control of disease.

  • The response to TKIs is assessed at specific time points from the beginning of treatment and is categorized as f...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Frequency depends on stage at presentation and response to first-line therapy.

  • Although splenomegaly persists, avoid contact sports or trauma to abdomen.

Patient Monitoring

REFERENCES

1
O’Brien SG, Guilhot F, Goldman JM, et al. International Randomized Study of Interferon versus STI571 (IRIS) 7-year follow-up: sustained survival, low rate of transformation and increased r...

ADDITIONAL READING

  • Kantarjian HM, Baccarani M, Jabbour E, et al. Second-generation tyrosine kinase inhibitors: the future of frontline CML therapy. Clin Cancer Res.  2011;17(7):1674–1683. [View A...

CODES

ICD10

  • C92.10 Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission

  • C92.11 Chronic myeloid leukemia, BCR/ABL-positive, in remission

  • C92.12 Chronic myeloid leukemia, BCR/ABL-posit...

CLINICAL PEARLS

  • CML belongs to the myeloproliferative disorders group.

  • The gold standard for diagnosis of CML is detection of the Philadelphia chromosome or its products, BCR-ABL mRNA, and fusion prote...

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