CML Flashcards
If a young woman presents with complaints of bruising, bleeding and enlarged spleen what would you suspect? What labs would you check?
Esential Thrombocytopnenia
CBC to check platlets (should be very high)
Hallmark sign of Chronic Myelofibrosis
Marrow fibrosis
For which types of CML would myelosuppresive treatment be considered?
Polycythemia Vera
Essential Thrombocytopenia
Chronic Myelofibrosis
Explain the difference between primary and secondary polycythemia?
polychythemia primary is a JAK2 mutation that leads to increased proliferation
Secondary polycythemia is a result of increased EPO/
Name some symptoms of Chronic Myelofibrosis
huge spleen, pallor/tachy, weakness
LIst and describe the 3 phases of CML
Chronic - Stable and controlled 3-4 years w/out treatment
Accelerated - Unstable - 6-12 months w/out treatment
Blast crisis - Acute leukemia with high mortality
3 types of remission for CML?
- Hematologic - no splenamegolay, normal labs
- Cytogenic - no t(9,22)
- Molecular - no BCR-ABL detected
LIst some common lab findings for CML?
Increased WBC count Neutrophilia with left shift Basophillia Decreased Hemoglobin Increased platelets Decreased LAB
The philadelphia chromosome leads to this problem with a tyrosine kinase
disregulation
Which type of CML presents with itching, headaches, and dizziness
PV
Which form of CML has the longest survival prognosis. Shortest?
CML
Chronic Myelofibrosis
Describe the required diagnostic signs for PV diagnosis
Increased red blood cell mass
Normal O2 saturation
plus some of the others (splenamegoly, thrombocytosis)
What is the treamtment for Essential Throbmocytothemia?
Platelet pheresis
myelosuppresive drugs
aspirin
Teardrop RBC are indicitive of this CML
Chronic Myelofibrosis
What are the 3 hallmarks for CML?
Increased WBC with left shift
Hypercellular marrow
Splenomegaly
