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    Chronic Myeloid Leukemia

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    asaleemna
    a type of blood cancer progressing slowly. it has 3 -phases. 1-chronic phase 2- accelrated phase 3- Blast phase

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    Chronic Myeloid Leukemia

    Uploaded by

    asaleemna
    154 views26 pages
    a type of blood cancer progressing slowly. it has 3 -phases. 1-chronic phase 2- accelrated phase 3- Blast phase

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    a type of blood cancer progressing slowly. it has 3 -phases. 1-chronic phase 2- accelrated phase 3- Blast phase

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    154 views26 pages

    Chronic Myeloid Leukemia

    Uploaded by

    asaleemna
    a type of blood cancer progressing slowly. it has 3 -phases. 1-chronic phase 2- accelrated phase 3- Blast phase

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 26

    Chronic Myeloid

    Leukemia
    Dr. Naveed Akhtar

    CHROMIC LEUKEMIA
    The chronic leukemias are a group of
    malignancies
    involving
    the
    hematopoietic
    system
    which
    progress slowly.There is an increase
    of abnormal white blood cells. It
    differs fromacute leukemia

    TYPE OF CHRONIC LEUKEMIA


    Chronic Lymphocytic Leukemia (CLL)

    Chronic Myeloid Leukemia(CML)

    DEFINITION OF CML
    CML is a clonal disorder of a pluripotent stem cell and
    is classifi ed as one of the myeloproliferative disorder.

    TYPES OF CHRONIC MYELOID


    LEUKEMIA
    WHO 2008
    Myeloproliferative
    neoplasms

    Old Classification
    Chronic Myeloid
    leukaemias

    Ch.myelogenous leukemia

    Polycythemia vera
    Essential thrombocythemia
    Primary myelofi brosis
    Chronic neutrophilic leuke
    Chronic eosinophilic leuke
    Mast cell disease
    MPNs, unclassifi able

    CML, Ph positive
    CML, Ph- (atypical)
    CGL
    Juvenile CML
    Ch. Neutrophilic
    leukaemia
    Eosinophilic
    leukaemia
    Ch. Myelomonocytic
    Leuk (CMML)

    CHRONIC MYELOGENOUS
    LEUKAEMIA
    Chronic Myelogenous/Myeloid
    Leukaemia (CML) is a
    myeloproliferative neoplasm that
    originates in an abnormal
    pluripotent bone marrow stem cell
    and is consistently associated with
    the BCR-ABL1 fusion gene located in
    the Philadelphia chromosome

    CHRONIC MYELOID LEUKEMIA


    CML is a myeloproliferative disorder
    characterized by increased proliferation of
    the granulocytic cell line without the loss of
    their capacity to diff erentiate. Consequently,
    the peripheral blood cell profi le shows an
    increased number of
    granulocytes and their
    immature precursors,
    including occasional
    blast cells.

    EPIDEMIOLOGY
    The disease accounts for around
    15% of leukemia.
    May occur at any age.

    MYELOID DEVELOPMENT STAGES

    PHILADELPHIA CHROMOSOME

    PHILADELPHIA CHROMOSOME
    Is the chromosome which result
    from the t(9;22)(q34;q11)part of
    the Abelson proto-oncogene ABL is
    moved
    to
    the
    BCR
    gene
    on
    chromosome
    22
    &
    part
    of
    chromosome
    22
    moves
    to
    chromosome
    9.
    The
    abnormal
    chromosome 22 is the Ph.

    CLINICAL PRESENTATION
    can occur in any age .But the
    mostly between 40-60.
    Symptoms related to hyper
    metabolism:
    weight loss,lassitude,anorexia or night sweats

    Gout or renal impairment


    caused by hyperuriceamia.
    Bone marrow failure: Anemia.

    Platelet dysfunction.Bruising,
    epistaxis, menorrhagia or
    hemorrhage
    Organ infiltration:
    Splenomegally almost always
    present and massive.
    Rare symptoms include
    visual disturbance.

    PHASES OF CML
    Chronic phase
    Accelerated phase
    Blast phase

    CHRONIC PHASE

    Blasts usually less than 2% TLC


    Absolute basophilia invariably present
    eosinophilia common
    Blast less than 5% of the marrow cells

    ACCELERATED PHASE

    Blasts more than 10%


    but less than 20

    BLAST PHASE

    Blasts more than 20%

    INVESTIGATION:
    CBC:
    Wbc is usually >50X10/l
    & some times >500X10/l.
    Normocytic normochromic anemia.
    Platelets .
    Peripheral blood fi lm:
    circulating basophil.
    Eosinophil

    INVESTIGATIONS
    Neutrophil alkaline phosphatase
    score is invariably low. But in
    infection it is very high

    INVESTIGATIONS
    BM: hypercellular with granulopoietic
    predominance .

    INVESTIGATIONS
    Cytogenetics/ FISH/ PCR:
    Detect pheladelphia
    chromosome.

    FISH
    The dual-color ABL (green) and
    BCR (red) probes span their respective
    breakpoint regions, producing two red
    and two green

    INVESTIGATIONS
    JAK2 V617F Mutation
    S.vitamin B12 & vitamin B12binding capacity are.
    S.Uric acid is usually.

    TREATMENT
    Chemotherapy:
    Tyrosine kinase inhibitor:
    Interferon-.
    Stem cell transplant.

    COURSE & PROGNOSIS


    Usually shows excellent response to
    chemtherapy in the chonic phase.
    Death usually occur from terminal
    acute trasformation ,hemorrhage or
    infection.

    THANK YOU

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