Chronic myelogenous leukemia laboratory tests

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

Overview

Characteristic complete blood count (CBC) features are as follows: absolute leukocytosis (median of 100,000/µL) with a left shift and classic “myelocyte bulge” (more myelocytes than the more mature metamyelocytes seen on the blood smear); blasts usually number <2%; absolute basophilia is nearly universal, with absolute eosinophilia in 90% of cases;¹¹ monocytosis is often seen, but generally not an increased monocyte percentage; absolute monocytosis is more prominent in the unusual cases with a p190 BCR-ABL;¹⁵ Platelet count is usually normal or elevated; thrombocytopenia suggests an alternative diagnosis or the presence of advanced stage, rather than chronic phase, disease.PMID:26434969

Laboratory findings consistent with the diagnosis of chronic myelogenous leukemia include

absolute leukocytosis (median of 100,000/µL) with a left shift

blasts usually number <2%

absolute basophilia is nearly universal

absolute eosinophilia

monocytosis

Laboratory Findings

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

Gallery

• 
  Blast crisis of chronic myelogenous leukemia (CML). Peripheral blood smear revealing the histopathologic features indicative of a blast crisis in the case of chronic myelogenous leukemia.
• 
  A photomicrograph of leukemia cells using Direct Fluorescent Antibody staining technique (DFA).

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