Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- splenomegaly
- shortness of breath
- left upper quadrant discomfort or fullness
- epistaxis
- arthralgia
- sternal tenderness
Outros fatores diagnósticos
- weight loss
- excessive sweating
- fever
- pallor
- bruising
- retinal hemorrhages
Fatores de risco
- age 65 to 74 years
- ionizing radiation exposure
- male sex
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- CBC
- complete metabolic profile
- peripheral blood smear
- bone marrow aspirate and biopsy for cytogenetic analysis
- quantitative reverse transcription PCR (qRT-PCR) including breakpoint analysis
- fluorescence in situ hybridization (FISH)
Investigações a serem consideradas
- mutational analysis
Algoritmo de tratamento
chronic phase
accelerated phase
Colaboradores
Autores
Michael J. Mauro, MD
Leader, Myeloproliferative Neoplasms Program, Leukemia Service
Attending Physician and Member
Memorial Sloan Kettering Cancer Center
Professor, Weill Cornell Medicine
New York
NY
Disclosures
MJM has received institutional research support for clinical trials from Novartis, Bristol Myers Squibb, Takeda, and Sun Pharma/Sparc, and honoraria for consulting/advisory boards from Novartis, Bristol Myers Squibb, Takeda, and Pfizer.
Acknowledgements
Dr Michael Mauro would like to gratefully acknowledge Dr Tim Somervaille, Dr Han Myint, and Dr Robert Chen, the previous contributors to this topic.
Disclosures
TS has received travel support and speaker expenses from Novartis, and has served as a consultant to Novartis for development of drugs for indications other than CML. HM sits on the advisory board of Novartis and Bristol Myers Squibb, and also does speaking engagements on their behalf. RC declares that he has no competing interests.
Peer reviewers
Rebecca Connor, MD
Chief Fellow
Section of Hematology and Oncology
Department of Internal Medicine
Wake Forest University Baptist Medical Center
Winston-Salem
NC
Disclosures
RC declares that she has no competing interests.
Richard E. Clark, MA, MD, FRCP, FRCPath
Professor of Haematology
Royal Liverpool University Hospital
Liverpool
UK
Declarações
None disclosed.
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Declarações
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Referências
Principais artigos
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: chronic myeloid leukemia [internet publication].Texto completo
Hochhaus A, Baccarani M, Silver RT, et al. European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia. Leukemia. 2020 Apr;34(4):966-84.Texto completo Resumo
Hochhaus A, Saussele S, Rosti G, et al. Chronic myeloid leukaemia: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017 Jul 1;28(Suppl 4):iv41-51.Texto completo Resumo
Smith G, Apperley J, Milojkovic D, et al. A British Society for Haematology guideline on the diagnosis and management of chronic myeloid leukaemia. Br J Haematol. 2020 Oct;191(2):171-93.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Leukemoid reaction
- Benign neutrophilic leukocytosis
- Atypical CML
Mais Diagnósticos diferenciais指南
- NCCN clinical practice guidelines in oncology: chronic myeloid leukemia
- NCCN clinical practice guidelines in oncology: hematopoietic cell transplantation (HCT)
Mais 指南医学计算器
EUTOS long-term survival (ELTS) score
Sokal score for chronic myeloid leukemia
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