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==Overview==
==Overview==
'''Chronic myelogenous leukemia''' ('''CML''') is a form of [[leukemia]] characterized by the increased and unregulated growth of predominantly [[myeloid]] cells in the [[bone marrow]] and the accumulation of these cells in the blood. CML is a clonal bone marrow [[stem cell]] disorder in which proliferation of mature [[granulocyte]]s ([[neutrophil]]s, [[eosinophil]]s, and [[basophil]]s) and their precursors is the main finding. It is a type of [[myeloproliferative disease]] associated with a characteristic [[chromosomal translocation]] called the [[Philadelphia chromosome]]. Historically, it has been treated with [[chemotherapy]], [[interferon]], [[bone marrow transplantation]], and[[targeted therapy|targeted therapies]], which was introduced at the beginning of the 21st century and have radically changed the management of chronic myelogenous leukemia.
'''Chronic myelogenous leukemia''' ('''CML''') is a form of [[leukemia]] characterized by the increased and unregulated growth of predominantly [[myeloid]] cells in the [[bone marrow]] and the accumulation of these cells in the blood. CML is a clonal bone marrow [[stem cell]] disorder in which proliferation of mature [[granulocyte]]s ([[neutrophil]]s, [[eosinophil]]s, and [[basophil]]s) and their precursors is the main finding. It is a type of [[myeloproliferative disease]] associated with a characteristic [[chromosomal translocation]] called the [[Philadelphia chromosome]]. Historically, it has been treated with [[chemotherapy]], [[interferon]], [[bone marrow transplantation]], and[[targeted therapy|targeted therapies]], which was introduced at the beginning of the 21st century and have radically changed the management of chronic myelogenous leukemia.
 
==Historical Perspective==
In the 1840s, the first cases of chronic myelogenous leukemia ([[splenomegaly]] with high [[leukocyte]] count) was reported in France, Germany, and Scotland. In 1960, the association of [[Philadelphia chromosome]] with the pathogenesis of  chronic myelogenous leukemia was first discovered. In 1973, (9;22) translocation was first discovered.<ref name="Goldman2010">{{cite journal|last1=Goldman|first1=John M.|title=Chronic Myeloid Leukemia: A Historical Perspective|journal=Seminars in Hematology|volume=47|issue=4|year=2010|pages=302–311|issn=00371963|doi=10.1053/j.seminhematol.2010.07.001}}</ref>
==Classification==
Chronic myelogenous leukemia may be classified according to the hematologic characteristics and laboratory findings into five subtypes: chronic granulocytic leukaemia (CGL), juvenile CML, chronic neutrophilic leukaemia (CNL), chronic myelomonocytic leukaemia (CMML) ,and atypical chronic myelogenous leukemia (aCML).<ref name="pmid3332855">{{cite journal| author=Shepherd PC, Ganesan TS, Galton DA| title=Haematological classification of the chronic myeloid leukaemias. | journal=Baillieres Clin Haematol | year= 1987 | volume= 1 | issue= 4 | pages= 887-906 | pmid=3332855 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3332855  }} </ref>
==Pathophysiology==
Genes involved in the pathogenesis of chronic myelogenous leukemia include [[BCR]] and [[ABL]].
<ref name="Hehlmann">{{cite journal|title=Chronic myeloid leukaemia|author=Hehlmann R, Hochhaus A, Baccarani M; European LeukemiaNet|journal=Lancet|volume=370|issue=9584|pages=342-50|date=2007|pmid=17662883}}</ref>
==Causes==
Chronic myelogenous leukemia is caused by a mutation in [[BCR|BCR-ABL]] gene.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/types/leukemia/patient/cml-treatment-pdq</ref>
==Differentiating Chronic myelogenous leukemia from other Diseases==
Chronic myelogenous leukemia must be differentiated from [[leukemoid reaction]], [[chronic neutrophilic leukemia]], and [[acute myeloid leukemia]].<ref name="pmid24839370">{{cite journal| author=Gajendra S, Gupta R, Chandgothia M, Kumar L, Gupta R, Chavan SM| title=Chronic Neutrophilic Leukemia with V617F JAK2 Mutation. | journal=Indian J Hematol Blood Transfus | year= 2014 | volume= 30 | issue= 2 | pages= 139-42 | pmid=24839370 | doi=10.1007/s12288-012-0203-6 | pmc=PMC4022913 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24839370  }} </ref>
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 13:29, 15 October 2015

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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 (CML) is a form of leukemia characterized by the increased and unregulated growth of predominantly myeloid cells in the bone marrow and the accumulation of these cells in the blood. CML is a clonal bone marrow stem cell disorder in which proliferation of mature granulocytes (neutrophils, eosinophils, and basophils) and their precursors is the main finding. It is a type of myeloproliferative disease associated with a characteristic chromosomal translocation called the Philadelphia chromosome. Historically, it has been treated with chemotherapy, interferon, bone marrow transplantation, andtargeted therapies, which was introduced at the beginning of the 21st century and have radically changed the management of chronic myelogenous leukemia.

Historical Perspective

In the 1840s, the first cases of chronic myelogenous leukemia (splenomegaly with high leukocyte count) was reported in France, Germany, and Scotland. In 1960, the association of Philadelphia chromosome with the pathogenesis of chronic myelogenous leukemia was first discovered. In 1973, (9;22) translocation was first discovered.[1]

Classification

Chronic myelogenous leukemia may be classified according to the hematologic characteristics and laboratory findings into five subtypes: chronic granulocytic leukaemia (CGL), juvenile CML, chronic neutrophilic leukaemia (CNL), chronic myelomonocytic leukaemia (CMML) ,and atypical chronic myelogenous leukemia (aCML).[2]

Pathophysiology

Genes involved in the pathogenesis of chronic myelogenous leukemia include BCR and ABL. [3]

Causes

Chronic myelogenous leukemia is caused by a mutation in BCR-ABL gene.[4]

Differentiating Chronic myelogenous leukemia from other Diseases

Chronic myelogenous leukemia must be differentiated from leukemoid reaction, chronic neutrophilic leukemia, and acute myeloid leukemia.[5]

References

  1. Goldman, John M. (2010). "Chronic Myeloid Leukemia: A Historical Perspective". Seminars in Hematology. 47 (4): 302–311. doi:10.1053/j.seminhematol.2010.07.001. ISSN 0037-1963.
  2. Shepherd PC, Ganesan TS, Galton DA (1987). "Haematological classification of the chronic myeloid leukaemias". Baillieres Clin Haematol. 1 (4): 887–906. PMID 3332855.
  3. Hehlmann R, Hochhaus A, Baccarani M; European LeukemiaNet (2007). "Chronic myeloid leukaemia". Lancet. 370 (9584): 342–50. PMID 17662883.
  4. National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/types/leukemia/patient/cml-treatment-pdq
  5. Gajendra S, Gupta R, Chandgothia M, Kumar L, Gupta R, Chavan SM (2014). "Chronic Neutrophilic Leukemia with V617F JAK2 Mutation". Indian J Hematol Blood Transfus. 30 (2): 139–42. doi:10.1007/s12288-012-0203-6. PMC 4022913. PMID 24839370.


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