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Chronic Myelogenous Leukemia (CML)
CML is a slow progressing myeloproliferative disorder characterized by increased immature granulocytic cell line usually occurs in adult or at old age and rarely in children. It is associated with increased Total WBC count (20-60K/uL) and mild to moderate anemia. The abnormal proliferation of stem cells producing granulocytes in the bone marrow is caused by a mutation at chromosome 9 ABL gene and chromosome 22 BCR gene. The reciprocal translocation of genetic material results in the formation of Philadelphia chromosome (Ph1), a diagnostic marker for CML. The Philadelphia chromosome is not passed from parent to child. Philadelphia Chromosome was first described by David Hungerford in 1959 at Lankenau Hospital’s Institute for Cancer Research along with Peter Nowell in Philadelphia, Pennsylvania.
There are at least 3 phases recognized in the progression of this disease. 1) Chronic phase – this is when fewer than 10% of the cells in the blood and bone marrow are blast cells. 2) Accelerated phase – this is when 10% to 19% of the cells are blast cells. 3) Blastic phase (“blast crisis”) – this is when 20% or more of the cells are blast cells.
