Chronic myelogenous leukemia overview: Difference between revisions
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==Risk factors== | ==Risk factors== | ||
The most potent risk factor in the development of chronic myelogenous leukemia is [[ionizing radiation]]; for example, increased rates of CML were seen in people exposed to the atomic bombings of Hiroshima and Nagasaki. Other risk factors include [[formaldehyde]], [[obesity]], and [[smoking]].<ref name="pmid3477299">{{cite journal| author=Moloney WC| title=Radiogenic leukemia revisited. | journal=Blood | year= 1987 | volume= 70 | issue= 4 | pages= 905-8 | pmid=3477299 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3477299 }} </ref><ref name="cancer.ca">Canadian Cancer Society.2015.http://www.cancer.ca/en/cancer-information/cancer-type/leukemia-chronic-myelogenous-cml/staging/?region=ab</ref> | The most potent risk factor in the development of chronic myelogenous leukemia is [[ionizing radiation]]; for example, increased rates of CML were seen in people exposed to the atomic bombings of Hiroshima and Nagasaki. Other risk factors include [[formaldehyde]], [[obesity]], and [[smoking]].<ref name="pmid3477299">{{cite journal| author=Moloney WC| title=Radiogenic leukemia revisited. | journal=Blood | year= 1987 | volume= 70 | issue= 4 | pages= 905-8 | pmid=3477299 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3477299 }} </ref><ref name="cancer.ca">Canadian Cancer Society.2015.http://www.cancer.ca/en/cancer-information/cancer-type/leukemia-chronic-myelogenous-cml/staging/?region=ab</ref> | ||
==Screening== | |||
According to the American Cancer Society, screening for chronic myelogenous leukemia is not recommended.<ref name="cancerorg">American Cancer Society.2015.http://www.cancer.org/cancer/leukemia-chronicmyeloidcml/detailedguide/leukemia-chronic-myeloid-myelogenous-detection</ref> | |||
==Natural History, Complications and Prognosis== | |||
If left untreated, majority of patients with chronic myelogenous leukemia may progress to develop [[fever]], night sweats, and [[fatigue]]. Common complications of chronic myelogenous leukemia include bleeding and[[anemia]]. Prognosis is generally poor, and the 5-year survival rate of patients with chronic myelogenous leukemia is approximately 59.9%.<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.</ref><ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/types/leukemia/hp/cml-treatment-pdq#link/_381_toc</ref> | |||
==Diagnosis== | |||
===History and Symptoms=== | |||
Revision as of 13:40, 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]
Epidemiology and Demographics
Chronic myelogenous leukemia (CML) occurs in all age groups, but most commonly in the middle-aged and elderly. CML affects slightly more men than women. CML represents about 15–20% of all cases of adult leukemia in Western populations.[6] In 2011, the age-adjusted incidence of CML was 1.81 per 100,000 persons in the United States.[7]
Risk factors
The most potent risk factor in the development of chronic myelogenous leukemia is ionizing radiation; for example, increased rates of CML were seen in people exposed to the atomic bombings of Hiroshima and Nagasaki. Other risk factors include formaldehyde, obesity, and smoking.[8][9]
Screening
According to the American Cancer Society, screening for chronic myelogenous leukemia is not recommended.[10]
Natural History, Complications and Prognosis
If left untreated, majority of patients with chronic myelogenous leukemia may progress to develop fever, night sweats, and fatigue. Common complications of chronic myelogenous leukemia include bleeding andanemia. Prognosis is generally poor, and the 5-year survival rate of patients with chronic myelogenous leukemia is approximately 59.9%.[7][4]
Diagnosis
History and Symptoms
References
- ↑ 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.
- ↑ Shepherd PC, Ganesan TS, Galton DA (1987). "Haematological classification of the chronic myeloid leukaemias". Baillieres Clin Haematol. 1 (4): 887–906. PMID 3332855.
- ↑ Hehlmann R, Hochhaus A, Baccarani M; European LeukemiaNet (2007). "Chronic myeloid leukaemia". Lancet. 370 (9584): 342–50. PMID 17662883.
- ↑ 4.0 4.1 National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/types/leukemia/patient/cml-treatment-pdq
- ↑ 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.
- ↑ Faderl S, Talpaz M, Estrov Z, Kantarjian HM (1999). "Chronic myelogenous leukemia: biology and therapy". Annals of Internal Medicine. 131 (3): 207–219. PMID 10428738.
- ↑ 7.0 7.1 Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.
- ↑ Moloney WC (1987). "Radiogenic leukemia revisited". Blood. 70 (4): 905–8. PMID 3477299.
- ↑ Canadian Cancer Society.2015.http://www.cancer.ca/en/cancer-information/cancer-type/leukemia-chronic-myelogenous-cml/staging/?region=ab
- ↑ American Cancer Society.2015.http://www.cancer.org/cancer/leukemia-chronicmyeloidcml/detailedguide/leukemia-chronic-myeloid-myelogenous-detection