Chronic myelogenous leukemia staging

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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

Chronic myelogenous leukemia may be classified according to the clinical characteristics and laboratory findings into three subtypes: chronic phase, accelerated phase, and blast crisis.

Classification

Chronic myelogenous leukemia is often divided into three phases based on clinical characteristics and laboratory findings.

Phases	Associations
Chronic phase	Most patients (85%) are diagnosed in this phase Less than 10% of cells in the blood and bone marrow are blasts Usually asymptomatic or mild symptoms my present Progress slowly Respond well to treatment
Accelerated phase	According to the World Health Organization diagnostic criteria, patient is considered to be in the accelerated phase if any of the following is present: 10–19% myeloblasts in the blood or bone marrow >20% basophils in the blood or bone marrow Platelet count <100,000, unrelated to therapy Platelet count >1,000,000, unresponsive to therapy Cytogenetic evolution with new abnormalities in addition to the Philadelphia chromosome Splenomegaly or increasing white blood cell count, unresponsive to therapy
Blast or acute phase	Disease acts more like an acute leukemia 30% of cells in blood and bone marrow are blast Blast cells often spread to tissues and organs outside the bone marrow Blast crisis may occur The accelerated phase can change quickly into the blast phase with symptoms of fever, malaise, and splenomegaly Usually symptomatic Bleeding and infections are common

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