Leukemia, Chronic Myelogenous
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- Chronic myelogenous leukemia (CML) is a myeloproliferative neoplasm characterized by clonal proliferation of myeloid precursors in the bone marrow with continuing differentiation into mature granulocytes.
- Hallmark of CML is Philadelphia chromosome (translocation t[9;22]).
- Natural history of the disease evolves in three clinical phases: a chronic phase, an accelerated phase, and a blast phase or crisis (transformation to acute leukemia).
- Per year, 1.6 cases/100,000 persons
- Predominant age: 50 to 60 years
- Predominant sex: male > female (1.3:1)
Accounts for 15–20% of adult leukemias
Etiology and Pathophysiology
Philadelphia chromosome is a balanced translocation between BCR (on chromosome 22) and ABL (on chromosome 9) genes t(9;22)(q34;q11). This fusion gene, BCR-ABL, codes for an abnormal, constitutively active tyrosine kinase that affects numerous signal transduction pathways, resulting in uncontrolled cell proliferation and reduced apoptosis.
Acquired genomic changes
Ionizing radiation exposure (uncommon)
None currently identified