小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 脾肿大
- 呼吸短促
- 左上腹不适或饱胀感
- 鼻衄
- 关节痛
- 胸骨压痛
其他诊断因素
- 体重减轻
- 多汗
- 发热
- 苍白
- 青肿
- 视网膜出血
危险因素
- 年龄 65~74 岁
- 电离辐射暴露
- 男性
诊断性检查
首要检查
- 全血细胞计数 (FBC）
- 全部代谢检测
- 外周血涂片
- 骨髓活检
- 细胞遗传学检查
- 包括断裂点分析的定量逆转录PCR（qRT-PCR）
- 荧光原位杂交 (FISH)
治疗流程
慢性期
加速期
急变期
异基因造血干细胞移植后复发，或存在异基因造血干细胞移植禁忌证
撰稿人
作者
Michael J. Mauro, MD
Leader, Myeloproliferative Neoplasms Program, Leukemia Service
Attending Physician and Member
Memorial Sloan Kettering Cancer Center
Professor, Weill Cornell Medicine
NY
利益声明
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.
鸣谢
Dr Michael Mauro would like to gratefully acknowledge Dr Tim Somervaille, Dr Han Myint, and Dr Robert Chen, the previous contributors to this topic.
利益声明
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.
同行评议者
Rebecca Connor, MD
Chief Fellow
Section of Hematology and Oncology
Department of Internal Medicine
Wake Forest University Baptist Medical Center
Winston-Salem
NC
利益声明
RC declares that she has no competing interests.
Richard E. Clark, MA, MD, FRCP, FRCPath
Professor of Haematology
Royal Liverpool University Hospital
Liverpool
UK
利益声明
None disclosed.
鉴别诊断
- 类白血病反应
- 良性中性粒细胞增多症
- 非典型CML
更多 鉴别诊断指南
- NCCN 肿瘤学临床实践指南：慢性髓系白血病
- 疑似癌症：识别和转诊
更多 指南
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