Chronic Myeloid Leukaemia

• What is chronic myeloid leukaemia?


  Myeloproliferative neoplasm

  Characterised by presence of Philadelphia chromosome

  Genetic alteration results in uncontrolled proliferation of myeloid cells in bone marrow
• What are the signs & symptoms of CML?


  Weight loss

  Tiredness

  Fever

  Sweating

  Massive splenomegaly

  Bleeding (due to thrombocytopenia)

  Gout

  Visual disturbance

  Confusion

  Priapism

  Deafness

  Weight loss

  Sweats

  Anorexia
• What are the DDx of chronic myeloid leukaemia?


  Reactive leukocytosis

  Polycythaemia vera (PV)

  Essential thrombocytopenia
• What is shown in the image?

  Blood film in CML

  
• What are the Inx of CML?


  Obs

  Full Hx & examination

  Bloods (FBC, blood film)

  Bone marrow biopsy

  Genetic testing
• What is the management of chronic myeloid leukaemia?


  Tyrosine kinase inhibitors

  Monitoring BCR-ABL levels

  Stem cell transplantation
• What are the reversible side effects of chronic myeloid leukaemia?


  Nausea

  Thrombocytopenia

  Neutropenia

  Fluid retention
• What are the possible complications of chronic myeloid leukaemia?


  Blast crisis

  Resistance to tyrosine kinase inhibitors

  Secondary malignancies