Extensive cutaneous manifestation: presenting feature of chronic myelocytic leukemia in second blast crisis
. Indian J of Dermatol 2010; 55(3):265-7.
of Cases Percentage (%) M0 2 8 M1 6 25 M2 13 55 M3 1 4 M4 2 8 M5 M6 M7 0 0 ALL (n= 12) L1 6 50 L2 6 50 L3 0 0 CML (n=17) Chronic phase 9 52 Accelerated phase 3 18 Blast crisis
3 18 Chronic Neutrophilic 1 6 leukaemia (CNL) Juvenile CML 1 6 CLL (n=3) 3 100 Table 4.
About 85-90% of new CML patients are diagnosed in the chronic phase, while blast crisis
occurs in about 10% of patients .
The termination of TKI therapy in the first trimester, owing to its potential teratogenicity, puts these patients at high risk for developing a blast crisis
, a serious and often life-threatening event that requires prompt and aggressive management.
CML in chronic phase can progress to blast crisis
at a rate of approximately 1% per year.
Calabretta and Perrotti (2004) discussed that chronic myelogenous leukemia has three clinical stages: chronic phase, accelerated phase, and blast crisis
. The blast crisis
phase is described as the rapid expansion of a population of myeloid blast cells.
(BC) phase was defined as peripheral blood blasts > 20% of peripheral blood white blood cells or nucleated bone marrow cells; extra medullary blast proliferation; and large foci or clusters of blasts on bone marrow biopsy.
Flow cytometry analyses of endothelial cells in venous blood samples from chronic myeloid leukemia (CML) patients in blast crisis
. A1, A2 and A3, corresponding isotypic control.
The presence of trisomy 19 as a new finding in a patient with a known diagnosis of CML is usually seen in patients with accelerated or blast crisis
Of clinical importance, they noted that sabutoclax, which suppresses all BCL2 anti-apoptotic proteins, renders these marrow-dwelling blast crisis
LSCs sensitive-and more susceptible-to TKI-based therapeutics at doses that do not harm normal progenitor cells.
Without effective therapy, chronic phase progresses through an accelerated phase into a rapidly fatal acute leukemia known as the blast crisis
, characterized by the appearance of immature cells in the blood and a less favorable response to treatment (reviewed in ).
A significant improvement in the time to progression to AP or blast crisis
was seen in the nilotinib arms.
As CML evolves and the blast count rises, the disease can enter an aggressive or accelerated phase and can terminate in an acute phase or blast crisis
when the blast count is greater than 20%.
Multiple BCR-ABL kinase domain mutations confer polyclonal resistance to the tyrosine kinase inhibitor imatinib (STI571) in chronic phase and blast crisis
chronic myeloid leukemia.
Washington, March 5 (ANI): Scientists in the US have discovered why a form of leukemia progresses from its more-treatable chronic phase to a life-threatening phase called blast crisis