Last reviewed: 1 Sep 2023
Last updated: 27 Jul 2023
Summary
Definition
History and exam
Key diagnostic factors
- splenomegaly
- fatigue
- malaise
- night sweats
- fever
- abnormal/excessive bleeding
- bone pain
More key diagnostic factors
Other diagnostic factors
- weight loss
- petechiae, ecchymoses, or easy bruising
- infection
- abdominal pain
- visual changes
- focal neurologic signs
- priapism
- tinnitus
- confusion or stupor
Other diagnostic factors
Risk factors
- history of chronic myeloid leukemia (CML)
- exposure to alkylating chemotherapeutic agents
- exposure to ionizing radiation
More risk factors
Diagnostic investigations
1st investigations to order
- CBC and differential
More 1st investigations to order
Investigations to consider
- peripheral blood smear
- bone marrow aspiration and biopsy
- fluorescence in situ hybridization
- quantitative reverse-transcriptase polymerase chain reaction
- flow cytometry
- mutational analysis
- HLA1 testing
- lumbar puncture
- serum leukocyte alkaline phosphatase
- serum vitamin B12
More investigations to consider
Treatment algorithm
ACUTE
lymphoid blast crisis
myeloid blast crisis
biphenotypic blast crisis
ONGOING
suboptimal response to initial treatment
partial hematologic response or second chronic phase
transplant failure or recurrence post-transplant
Contributors
Authors
Carlos Palacio, MD, MPH, FACP

Professor of Medicine
University of Florida College of Medicine
Jacksonville
FL
Disclosures
CP declares that he has no competing interests.
Marwan E. Shaikh, MD
Assistant Professor
College of Medicine
Division of Hematology and Oncology
Mayo Clinic Jacksonville
Jacksonville
FL
Disclosures
MES declares that he has no competing interests.
Acknowledgements
Dr Carlos Palacio and Dr Marwan E. Shaikh would like to gratefully acknowledge Fauzia Rana, a previous contributor to this topic.
Disclosures
FR declares that she has no competing interests.
Peer reviewers
Danilo Perrotti, MD, PhD
Assistant Professor of Human Cancer Genetics
Ohio State University
Columbus
OH
Disclosures
DP declares that he has no competing interests.
Differentials
- Organ-specific or systemic infection (bacterial, fungal, viral)
- Leukemoid reaction
- Essential thrombocythemia
More DifferentialsGuidelines
- Chronic myeloid leukemia
- Guideline on the diagnosis and management of chronic myeloid leukaemia
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