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chronic myeloid leukemia (CML) blast crisis
Pathology:
1) myelofibrosis
2) cytogenetic abnormalities precede blast crisis by 6 months
Genetics:
1) duplication of Philadelphia chromosome may occur
2) trisomy 8 may occur
3) other implicated genes CDCA7
Clinical manifestations:
1) splenomegaly
2) lymphadenopathy
3) bone pain
4) fever
5) headache
Laboratory:
1) blast count > 20%
2) increase in anemia
3) thrombocytopenia
4) basophilia
Complications: cerebral hemorrhage
Management:
1) allopurinol
2) fluids
3) hydroxyurea
4) cranial radiation
5) leukocyte apheresis
6) often resistant to chemotherapy
Interactions
disease interactions
General
acute myeloid leukemia (AML)
References
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 434
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998