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Leukemia, Chronic Myelogenous

Leukemia, Chronic Myelogenous is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • 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).

Epidemiology

Incidence
  • Per year, 1.6 cases/100,000 persons
  • Predominant age: 50 to 60 years
  • Predominant sex: male > female (1.3:1)

Prevalence
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.

Genetics
Acquired genomic changes

Risk Factors

Ionizing radiation exposure (uncommon)

General Prevention

None currently identified

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Citation

Stephens, Mark B., et al., editors. "Leukemia, Chronic Myelogenous." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117534/all/Leukemia__Chronic_Myelogenous.
Leukemia, Chronic Myelogenous. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117534/all/Leukemia__Chronic_Myelogenous. Accessed April 18, 2019.
Leukemia, Chronic Myelogenous. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117534/all/Leukemia__Chronic_Myelogenous
Leukemia, Chronic Myelogenous [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 18]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117534/all/Leukemia__Chronic_Myelogenous.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Leukemia, Chronic Myelogenous ID - 117534 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117534/all/Leukemia__Chronic_Myelogenous PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -