ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferencesView all Images (3)
Chronic myeloid leukemia in Adult
Print
Other Resources UpToDate PubMed

Chronic myeloid leukemia in Adult

Print Images (3)
Contributors: Nina Haghi MD, Carla Casulo MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Chronic myeloid leukemia (CML), also known as chronic myelogenous leukemia, is a myeloproliferative disorder defined by a unique molecular / cytogenetic abnormality in which a balanced translocation between chromosomes 9 and 22 occurs to create the Philadelphia (Ph) chromosome [t(9;22)(q34;q11.2)]. The novel BCR-ABL1 fusion oncogene codes for a protein with tyrosine kinase activity that is constitutively active, leading to activation of many downstream pathways. The result is excessive proliferation and reduced apoptosis of CML cells, causing reduced hematopoiesis.

CML represents about 15%-20% of all leukemias in the United States. Median age at diagnosis is between 50 and 65 years, and there is a slight male predominance.

CML begins in the chronic phase (CP); this may progress to an accelerated phase (AP) and, later, a blast phase (BP), or acute leukemia (> 20% blasts). Approximately 85% of patients will be in CP when they present or are diagnosed.

For more information, see OMIM.

Related topic: Acute myelogenous leukemia

Codes

ICD10CM:
C92.10 – Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission

SNOMEDCT:
92818009 – Chronic myeloid leukemia, disease

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

  • Leukemoid reaction – reactive nonclonal proliferation of WBC due to infection or stress
  • Chronic lymphoid leukemia – increased WBC; however, differential shows they are lymphocytes
  • Chronic neutrophilic leukemia – elevated WBC comprised of predominantly neutrophils (80%) along with circulating blasts may be associated with mutation in CSF3R, which is a growth factor receptor
  • Acute myeloid leukemia – increased WBC made up of > 20% myeloblasts
  • Acute lymphoid leukemia – increased WBC made up of > 20% lymphoblasts

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required

References

Subscription Required

Last Reviewed: 06/11/2019
Last Updated: 06/21/2019
Copyright © 2019 VisualDx®. All rights reserved.
Chronic myeloid leukemia in Adult
Print 3 Images
View all Images (3)
(with subscription)
Chronic myeloid leukemia : Abdominal pain, Fatigue, Fever, Night sweats, Abdominal distension, Weight loss, Anorexia, Anemia, Pallor, Splenomegaly, WBC elevated, PLT increased, Basophilia
Clinical image of Chronic myeloid leukemia
Copyright © 2019 VisualDx®. All rights reserved.