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Leukemia, Chronic Myelogenous

Jan Cerny, PhD, MD and Erin Thomas, M.D. Reviewed 05/2023
 


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 incidentally during routine screening (up to 50%). 

HISTORY

  • Chronic phase: fatigue, weight loss, night sweats, abd...

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
Hochhaus A, Larson RA, Guilhot F, et al. Long-term outcomes of imatinib treatment for chronic myeloid leukemia. N Engl J Med. 2017;376(10):917-927.

ADDITIONAL READING

Jabbour E, Kantarjian H. Chronic myeloid leukemia: 2022 update on diagnosis, therapy and monitoring.  Am J Hematol. 2022;97(9):1236-1256.  

CODES

ICD10

  • C92.2 Atypical chronic myeloid leukemia, BCR/ABL-negative

  • C92.12 Chronic myeloid leukemia, BCR/ABL-positive, in relapse

  • C92.22 Atypical chronic myeloid leukemia, BCR/ABL-negative, in relapse

  • C...

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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