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Medical Grand Rounds

Your patient has chronic leukemia: Now what?

Matt Kalaycio, MD, FACP
Cleveland Clinic Journal of Medicine August 2016, 83 (8) 575-581; DOI: https://doi.org/10.3949/ccjm.83gr.16002
Matt Kalaycio
Chairman, Department of Hematology and Medical Oncology, and Staff, Transplantation Center and Department of Cancer Biology, Taussig Cancer Center, Cleveland Clinic
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    TABLE 1

    Phases of chronic myelogenous leukemia

    CharacteristicChronicAcceleratedBlastic
    Blasts (%)1–15≥ 15≥ 30
    Basophils (%)Increased≥ 20Any number
    PlateletsIncreased or normalIncreased or decreasedDecreased
    Bone marrowMyeloid hyperplasia
    Duration4–6 yearsUp to 1 year3–6 months
    • Based on information in references 3 and 4.

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    TABLE 2

    Staging of chronic lymphocytic leukemia

    StageSimplified 3-stage systemClinical featuresMedian survival (years)
    0Low riskLymphocytosis in blood and marrow only> 10
    IIntermediate riskLymphadenopathy7
    IISplenomegaly with or without hepatomegaly
    IIIHigh riskAnemia1.5–4
    IVThrombocytopenia
    • Based on information in reference 19.

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    TABLE 3

    Indications to initiate treatment for chronic lymphocytic leukemia

    Constitutional symptoms attributable to the disease
    Progressive marrow failure
    Autoimmune anemia or thrombocytopenia poorly responsive to corticosteroids
    Massive or progressive splenomegaly
    Massive or progressive lymphadenopathy
    Rapid lymphocyte doubling time
    • Based on information in reference 30.

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Cleveland Clinic Journal of Medicine: 83 (8)
Cleveland Clinic Journal of Medicine
Vol. 83, Issue 8
1 Aug 2016
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Your patient has chronic leukemia: Now what?
Matt Kalaycio
Cleveland Clinic Journal of Medicine Aug 2016, 83 (8) 575-581; DOI: 10.3949/ccjm.83gr.16002

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Your patient has chronic leukemia: Now what?
Matt Kalaycio
Cleveland Clinic Journal of Medicine Aug 2016, 83 (8) 575-581; DOI: 10.3949/ccjm.83gr.16002
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    • ABSTRACT
    • CHRONIC MYELOGENOUS LEUKEMIA
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