Stage Information for Chronic Myelogenous Leukemia
Accelerated-phase CML is characterized by 10% to 19% blasts in either the peripheral blood or bone marrow.
Blastic-phase CML is characterized by 20% or more blasts in the peripheral blood or bone marrow.
When 20% or more blasts are present in the face of fever, malaise, and progressive splenomegaly, the patient has entered blast crisis.
Relapsed CML is characterized by any evidence of progression of disease from a stable remission. This may include the following:
- Increasing myeloid or blast cells in the peripheral blood or bone marrow.
- Cytogenetic positivity when previously cytogenetic-negative.
- FISH positivity for BCR/ABL (breakpoint cluster region/Abelson) translocation when previously FISH-negative.
Detection of the BCR/ABL translocation by RT-PCR during prolonged remissions does not constitute relapse on its own. However, exponential drops in quantitative RT-PCR measurements for 3 to 12 months correlates with the degree of cytogenetic response, just as exponential rises may be associated with quantitative RT-PCR measurements that are closely connected with clinical relapse.
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