Clinical and Immunological Outcome in Chronic Myloid Leukemic Patients Treated With Tyrosine Kinase Inhibitor: Assuit University Hospitals Insight

Chronic myelogenous leukemia (CML) is a myeloproliferative disorder in which leukemic cells display the Philadelphia chromosome generated from a reciprocal t(9:22) (q34:q11) translocation.1 The chromosome 9 and chromosome 22 transposal of t (9:22) and (q34:q11) causes the cancer gene C-ABL at 9q34 to link with the BCR gene at 22q11, forming the BCR-ABL gene on chromosome 22.2 CML is presented by constitutional complaints (fatigue, weight loss, and fever), those related to splenomegaly (abdominal fullness, anorexia, abdominal pain, and early satiety) and bleeding tendency (easy bruising or bleeding) are most frequent symptoms. Splenomegaly (≥ 95%), sternal tenderness, hepatomegaly, purpura, and retinal hemorrhage are commonly reported signs at physical exam. To diagnose CML, doctors use a variety of tests to analyze the blood and marrow cells.

*Complete Blood Count (CBC). This test is used to measure the number and types of cells in the blood. People with CML often have:

• Decreased hemoglobin concentration
• Increased white blood cell count, often to very high levels
• Possible increase or decrease in the number of platelets depending on the severity

Blood cells are stained (dyed) and examined with a light microscope. These samples show:

• Specific pattern of white blood cells
• Small proportion of immature cells (leukemic blast cells and promyelocytes)
• Larger proportion of maturing and fully matured white blood cells (myelocytes and neutrophils).