Question
Which one of the following is not a criterion for making a diagnosis of chronic myeloid leukemia in accelerated phase:
A. Blasts 10-19% of WBC’s in peripheral blood
B. Basophils 10-19% of WBC’S in peripheral blood
C. Increasing spleen size unresponsive to therapy
D. Persistent thrombocytosis (>1000 x 109/L) unresponsive to therapy
Show Answer
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Correct Answer » D
Explanation
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Answer is D (Persistent thrombocytosis > 1000 x 109/L positive to therapy)
Accelerated phase is associated with thrombocytopenia (9/L) and not thrombocytosis.
Although multivariate analysis derived criteria also place blood or marrow basophils > 20% in disease criteria, other criteria do consider marrow and peripheral basophils > 10% as a criteria and hence option (D) is the single best answer here.
Accelerated phase of CML: It is defined by the development of increasing degrees of anemia unaccounted for by bleeding or chemotherapy and is defined by several criteria.
| Multivariate analysis derived criteria |
Other commonly used criteria |
| Cytogenetic clonal evolution |
| Blood or marrow blasts between 10 and 20% |
Increasing drug dosage requirement |
| Blood or marrow basophils > 20% |
Marrow reticulum or collagen fibrosis |
| Platelet count < 100 x 10°/L unrelated to therapy |
Marrow or peripheral blasts > 10% |
| Marrow or peripheral basophils eosinophils – 10% Triad of WBC > 50 x 109/L, haematocrit < 25% and Mai,100 liP/L not controlled ii1111 therapy Unexplained fever or bone pain |
