Chronic myelogenous leukemia history and symptoms: Difference between revisions

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Revision as of 18:52, 12 May 2018

Clinical features, when present, are generally nonspecific

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]

Overview

Up to 50% of patients with CML are asymptomatic and clinical features, when present, are generally nonspecific. Common symptoms of CML include fatigue, weight loss, malaise, easy satiety, and left upper quadrant fullness or pain. Less common symptoms of CML include bleeding, thrombosis, gouty arthritis, symptoms of hyperviscosity including priapism, retinal hemorrhages, and upper gastrointestinal ulceration and bleeding. Dyspnea, drowsiness, loss of coordination, and confusion due to sludging in the pulmonary or cerebral vessels, are uncommon symptoms.

PMID:24729196/PMID:26434969

Patients with CML usually appear Splenomegaly. Hepatomegaly is less common. Lymphadenopathy and infiltration of skin or other tissues are uncommon.

Headaches, bone pain, arthralgias, pain from splenic infarction, and fever are more frequent with CML transformation. Most patients evolve into AP prior to BP, but 20% transit into BP without AP warning signals. AP might be insidious or present with worsening anemia, splenomegaly, and organ infiltration; BP presents as an acute leukemia with worsening constitutional symptoms, bleeding, fever, and infections.PMID:24729196

low platelet count and/or platelet dysfunction

thrombocytosis and/or marked leukocytosis

elevated uric acid levels

marked leukocytosis or thrombocytosis

elevated histamine levels due to basophilia

Symptoms

References

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+Clinical features, when present, are generally nonspecific
 __NOTOC__
 {{Chronic myelogenous leukemia}}
 {{CMG}} {{AE}} {{MJK}}
 ==Overview==
-About 30 to 50% of patients with CML diagnosed in the United States are asymptomatic. The disease is found on routine physical examination or
+Up to 50% of patients with CML are asymptomatic and clinical features, when present, are generally nonspecific. Common symptoms of CML include fatigue, weight loss, malaise, easy satiety, and left upper quadrant fullness or pain. Less common symptoms of CML include bleeding, thrombosis, gouty arthritis, symptoms of hyperviscosity including priapism, retinal hemorrhages, and upper gastrointestinal ulceration and bleeding. Dyspnea, drowsiness, loss of coordination, and confusion due to sludging in the pulmonary or cerebral vessels, are uncommon symptoms.
+PMID:24729196/PMID:26434969
+Patients with CML usually appear Splenomegaly. Hepatomegaly is less common. Lymphadenopathy and infiltration of skin or other tissues are uncommon.
+Headaches, bone pain, arthralgias, pain from splenic infarction, and fever are more frequent with CML transformation. Most patients evolve into AP prior to BP, but 20% transit into BP without AP warning signals. AP might be insidious or present with worsening anemia, splenomegaly, and organ infiltration; BP presents as an acute leukemia with worsening constitutional symptoms, bleeding, fever, and infections.PMID:24729196
-blood tests. PMID:24729196
+low platelet count and/or platelet dysfunction
-Common signs and symptoms of CML in CP, when present, result from anemia and splenomegaly. These include fatigue, weight loss, malaise, easy satiety, and left upper quadrant fullness or pain. Rare manifestations include bleeding (associated with a low platelet count and/or platelet dysfunction), thrombosis (associated with thrombocytosis and/or marked leukocytosis), gouty arthritis (from elevated uric acid levels), priapism (usually with marked leukocytosis or thrombocytosis), retinal hemorrhages, and upper gastrointestinal ulceration and bleeding (from elevated histamine levels due to basophilia). Leukostatic symptoms (dyspnea, drowsiness, loss of coordination, and confusion) due to sludging in the pulmonary or cerebral vessels, are uncommon in CP despite WBC counts exceeding 100 3109/L. Splenomegaly is the most consistent physical sign in CML, and is detected in 50–60% of cases. Hepatomegaly is less common (10–20%).Lymphadenopathy and infiltration of skin or other tissues are uncommon. When present, they favor Ph-negative CML or AP or BP of CML. Headaches, bone pain, arthralgias, pain from splenic infarction, and fever are more frequent with CML transformation. Most patients evolve into AP prior to BP, but 20% transit into BP without AP warning signals. AP might be insidious or present with worsening anemia, splenomegaly, and organ infiltration; BP presents as an acute leukemia with worsening constitutional symptoms, bleeding, fever, and infections.PMID:24729196
+thrombocytosis and/or marked leukocytosis
-Up to 50% of patients are asymptomatic and diagnosed incidentally after routine laboratory evaluation.<sup>12</sup> Clinical features, when present, are generally nonspecific: splenomegaly is present in 46–76%<sup>12, 13</sup> and may cause left upper quadrant pain or early satiety; fatigue, night sweats, symptoms of anemia and bleeding due to platelet dysfunction may occur, the latter most commonly in patients with marked thrombocytosis; <5% of patients present with symptoms of hyperviscosity, including priapism; these are generally seen when the presenting white cell count (WCC) exceeds 250,000/µL.<sup>13</sup>
+elevated uric acid levels
-The disease is classically staged into chronic phase (CP, most patients at presentation), accelerated phase (AP) and blast phase (BP).<sup>11</sup> Many definitions have been used for these stages, but all the data generated from the tyrosine kinase inhibitor (TKI) studies has used the historically standard definition where AP is defined by the presence of one or more of the following: ≥15% blasts in PB/BM, ≥20% basophils in PB, platelets <100,000/µL unrelated to treatment or the development of cytogenetic evolution. Blast phase is defined by the presence of ≥30% blasts in the peripheral blood or bone marrow, the presence of clusters of blasts in marrow or the presence of extramedullary disease with immature cells (i.e., a myeloid sarcoma).<sup>14</sup> Progression to BP occurs at a median of 3–5 years from diagnosis in untreated patients, with or without an intervening identifiable AP.
+marked leukocytosis or thrombocytosis
-PMID:26434969
+elevated histamine levels due to basophilia
 ==Symptoms==

Chronic myelogenous leukemia history and symptoms: Difference between revisions

Revision as of 18:52, 12 May 2018

Overview

Symptoms

References

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