Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- esplenomegalia
- fadiga
- mal-estar
- sudorese noturna
- febre
- sangramento anormal/excessivo
- dor óssea
Outros fatores diagnósticos
- perda de peso
- petéquias, equimoses ou facilidade para adquirir hematomas
- infecção
- dor abdominal
- alterações visuais
- sinais neurológicos focais
- priapismo
- zumbido
- confusão ou estupor
Fatores de risco
- história de leucemia mieloide crônica (LMC)
- exposição a agentes quimioterápicos alquilantes
- exposição a radiação ionizante
Diagnostic investigations
1st investigations to order
- hemograma completo e diferencial
Investigations to consider
- esfregaço de sangue periférico
- aspiração e biópsia de medula óssea para análise citogenética
- reação em cadeia da polimerase via transcriptase reversa quantitativa (qRT-PCR)
- hibridização in situ fluorescente
- citometria de fluxo
- análise mutacional
- Teste de HLA1
- punção lombar
- fosfatase alcalina leucocitária sérica
- vitamina B12 sérica
Treatment algorithm
crise blástica linfoide
crise blástica mieloide
crise blástica bifenotípica
resposta insatisfatória ao tratamento inicial
resposta hematológica parcial e segunda fase crônica
falha do transplante ou recorrência pós-transplante
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.
利益声明
FR declares that she has no competing interests.
同行评议者
Danilo Perrotti, MD, PhD
Assistant Professor of Human Cancer Genetics
Ohio State University
Columbus
OH
利益声明
DP declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: chronic myeloid leukemia [internet publication].全文
Smith G, Apperley J, Milojkovic D, et al; British Society for Haematology. A British Society for Haematology guideline on the diagnosis and management of chronic myeloid leukaemia. Br J Haematol. 2020 Oct;191(2):171-93.全文 摘要
Hochhaus A, Saussele S, Rosti G, et al; ESMO Guidelines Committee. Chronic myeloid leukaemia: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017 Jul 1;28(suppl 4):iv41-51.全文 摘要
Hochhaus A, Baccarani M, Silver RT, et al. European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia. Leukemia. 2020 Apr;34(4):966-84.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Infecção específica de órgãos ou sistêmica (bacteriana, fúngica, viral)
- Reação leucemoide
- Trombocitemia essencial
更多 鉴别诊断指南
- Chronic myeloid leukemia
- NCCN clinical practice guidelines in oncology: hematopoietic cell transplantation (HCT)
更多 指南
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