On the basis of morphology and cytochemistry, the possibility of acute basophilic leukemia and basophilic blast crisis
of CML was considered.
Relapse into blast crisis
following bone marrow transplantation for chronic myeloid leukaemia: a report of five cases.
Extensive cutaneous manifestation: presenting feature of chronic myelocytic leukemia in second blast crisis
Of the 20 with lymphoid blast crisis
or acute lymphocytic leukemia, 70 percent had a response, including four with complete responses, the researchers said.
Approximately 3 years after the diagnosis of chronic phase CML, metamorphosis through periods of accelerated growth and blast crisis
Depending upon the type of cells involved in blast crisis
, aggressive chemotherapy may again reverse the disease.
After a chronic phase of production of too many white blood cells, CML typically evolves to the more aggressive phases referred to as accelerated phase and blast crisis
It is typically slow-growing and often not diagnosed until its later stages when there can be a sudden, dramatic increase in malignant cells, known as blast crisis
The company said Imatinib mesylate tablets are indicated for newly diagnosed adult and pediatric patients with Philadelphia chromosome positive chronic myeloid leukemia (Ph+ CML) in chronic phase as well as in patients with Ph+ CML in blast crisis
, accelerated phase, or in chronic phase after failure of interferon-alpha therapy.
Further, this study also demonstrated that the combination of pacritinib at low nanomolar concentrations with dasatinib may eliminate self-renewing leukemia stem cells in blast crisis
of chronic myeloid leukemia (CML) with minimal toxicity toward normal progenitors.
Although, with CML, blast crisis
can occur, making it behave much more like an acute leukemia.
The Bone marrow pictures in CML without treatment showing hypercellularity due to excessive proliferation of the granulocytes with myelocytes predominantly and presence of blast cells from <10% to >20% in the bone marrow and peripheral blood according to the world health organization criteria that divide the CML in to chronic, accelerated phases and blast crisis
, there is decreased or normal or increased megekayrioposis as well as moderate to marked reticulin fibrosis with presence of small megakaryocyte containing hypolobulated nuclei, sea-blue histiocytes and gaucher cell and these changes are return to the normal state after treatment and the immunohisto-chemistry is used for differentiating the myeloblastic and lymphoblastic crisis of CML [7,8].
The manifestations of blast crisis
are similar to acute leukemia.
There have been a few case reports published of Philadelphia chromosome-positive acute myeloid leukemia (Ph+ AML) presenting as megakaryoblastic blast crisis
The blast crisis
is the final phase of CML when overabundant, abnormal white blood cells crowd out healthy cells, causing serious dysfunction.