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Crise blástica

Last reviewed: 12 Jun 2025
Last updated: 29 Nov 2024

Summary

Definition

History and exam

Key diagnostic factors

  • esplenomegalia
  • fadiga
  • mal-estar
  • sudorese noturna
  • febre
  • sangramento anormal/excessivo
  • dor óssea
Full details

Other diagnostic factors

  • perda de peso
  • petéquias, equimoses ou facilidade para adquirir hematomas
  • infecção
  • dor abdominal
  • alterações visuais
  • sinais neurológicos focais
  • priapismo
  • zumbido
  • confusão ou estupor
Full details

Risk factors

  • história de leucemia mieloide crônica (LMC)
  • exposição a agentes quimioterápicos alquilantes
  • exposição a radiação ionizante
Full details

Diagnostic investigations

1st investigations to order

  • hemograma completo e diferencial
Full details

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
Full details

Treatment algorithm

ACUTE

crise blástica linfoide

crise blástica mieloide

crise blástica bifenotípica

ONGOING

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
Carlos Palacio

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: chronic myeloid leukemia [internet publication].Full text

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.Full text  Abstract

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.Full text  Abstract

Hochhaus A, Baccarani M, Silver RT, et al. European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia. Leukemia. 2020 Apr;34(4):966-84.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Crise blástica images
  • Differentials

    • Infecção específica de órgãos ou sistêmica (bacteriana, fúngica, viral)
    • Reação leucemoide
    • Trombocitemia essencial
    More Differentials
  • Guidelines

    • Chronic myeloid leukemia
    • NCCN clinical practice guidelines in oncology: hematopoietic cell transplantation (HCT)
    More Guidelines
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