General measures Nicotine restriction (refraining from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Normal weight to strive for or maintain!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis. BMI ≥ 25 → participation in a medically … Acute Myeloid Leukemia: Therapy
Medical history (history of illness) represents an important component in the diagnosis of chronic myeloid leukemia (CML). Family history What is the general health status of your relatives? Are there any hereditary diseases in your family? Social history What is your profession? Are you exposed to harmful working substances in your profession? Current medical history/systemic … Chronic Myeloid Leukemia: Medical History
Blood, blood-forming organs-immune system (D50-D90). Essential thrombocythemia (ET) – chronic myeloproliferative disorder (CMPE, CMPN) characterized by chronic elevation of platelets (thrombocytes). Osteomyelofibrosis (OMF) – myeloproliferative syndrome; represents a progressive disease of the bone marrow. Polycythaemia vera – pathological multiplication of blood cells (particularly affected are: especially erythrocytes/red blood cells, to a lesser extent also platelets … Chronic Myeloid Leukemia: Or something else? Differential Diagnosis
Chronic myeloid leukemia (CML) often progresses with three phases of disease: Chronic phase Accelerated phase – transition between chronic phase and blast crisis. Blast crisis -phase of the disease in which there is a crisis occurrence of immature white blood cells (blasts; promyelocytes) in the blood;develops in two-thirds of affected individuals. The following symptoms and … Chronic Myeloid Leukemia: Symptoms, Complaints, Signs
Pathogenesis (disease development) CML a clonal myeloproliferative disorder characterized by translocation of the long arms of chromosomes 9 and 22, t(9;22)(q34;q11): In chronic myeloid leukemia, malignant degeneration of a pluripotent stem cell of the bone marrow occurs. Initial chromosomal damage occurs with translocation t(9;22), Philadelphia chromosome (obsolete Ph1; 95% of cases), or the bcr-abl fusion … Chronic Myeloid Leukemia: Causes
General measures Nicotine restriction (abstaining from tobacco use)Note: Smoking doubles the mortality risk (risk of death) of patients with chronic myeloid leukemia (CML) Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Normal weight to strive for or maintain!Determination of BMI (body mass index, body mass index) … Chronic Myeloid Leukemia: Therapy
The following are the major diseases or complications that may be contributed to by chronic myeloid leukemia (CML): Respiratory system (J00-J99) Pulmonary insufficiency – inability of the lungs to perform adequate gas exchange. Eyes and eye appendages (H00-H59). Visual disturbances due to vascular occlusion Blood, hematopoietic organs – immune system (D50-D90) Anemia (anemia) Thrombocytopenia – … Chronic Myeloid Leukemia: Complications
WHO classification of chronic myeloid leukemia/myeloproliferative neoplasia. Chronic phase <15% blasts (immature white blood cells) in the blood or bone marrow. Accelerated phase 15-19% blasts in blood or bone marrow or ≥ 20 % basophilia in the blood (increase in basophilic granulocytes/subgroup of leukocytes (white blood cells)) – indication that the severity of the disease … Chronic Myeloid Leukemia: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye) [accompanying symptom of chronic phase: night sweats]. Abdomen (abdomen) Shape of the abdomen? Skin color? Skin … Chronic Myeloid Leukemia: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count [continuous left shift; leukocytosis/increase in white blood cells (leukocytes), erythrocytosis/increase in red blood cells (erythrocytes), thrombocytosis/increase in platelets (thrombocytes)] Differential blood count [leukocytosis with basophilia] Coagulation parameters – Quick, PTT (partial thromboplastin time). Inflammatory parameters – CRP (C-reactive protein). Alkaline leukocyte phosphatase (ALP; leukocyte … Chronic Myeloid Leukemia: Test and Diagnosis
Therapeutic targets Improvement of the symptomatology Remission (disappearance of disease symptoms). Prolongation of survival time Healing Therapy recommendations Initiation of therapy before obtaining BCR-ABL status: hydroxyurea (40 mg/kg bw) if leukocyte count > 100,000/μl (avoidance of leukostasis/aggregation of leukocytes in blood vessels resulting in vascular occlusion). Prophylaxis of tumor lysis syndrome (TLS; life-threatening metabolic derailment … Chronic Myeloid Leukemia: Drug Therapy
Mandatory medical device diagnostics. Abdominal ultrasonography (ultrasound examination of the abdominal organs) – for basic diagnosis. Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification. Computed tomography (CT; cross-sectional imaging procedure (radiographs taken from different directions with computer-based … Chronic Myeloid Leukemia: Diagnostic Tests
