•Chronic leukemia are a heterogenous group of malignant proliferation of hemopoietic stem cells. Mode of onset usually insidious, slowly progressive and survival of the patient for months or years without treatment.

Types

•1) Chronic granulocytic leukemia.

•2)Chronic lymphocytic leukemia.

Chronic granulocytic leukaemia

Synonyms are

1.Chronic myeloid Leukaemia

2.Chronic myelocytic leukaemia

3.Chronic myelogenous leukaemia

Clinical Features

Age incidence : 30 – 60 years

Average – 45 years

Common – Anaemia, Spleenomegali, Fatigue, Weight loss.

Less common- Night sweat, Bruising

Occasional- Bone and joint pain,Amenorrhoea.

Laboratory diagnosis

1) Blood picture-

 A) Routine – Hb- moderately reduce (7-9 gm\ cumm).

                   WBC- Markedly elevated, up to 500000\ cumm. Basophil- 2- 10%.

                    ESR- Raised.

B) PBF

§RBC – Usually normocytic and normochromic.

§WBC – Markedly elevated total count, with a full spectrum of cells of granulocytic series. Segmented  neutrophil and myelocytes  constitutes majority cells.Myelocytes    comprise 10- 50%. Blast up to 10%.

§Platelet – Raised in early stage and reduced in     late stage

2) Bone marrow

nCellularity – Hyper cellular.

nM : E ratio – Increased.

nErythropoiesis – Mild increase.

nLeukopoiesis – Hyperactive. Majority of    cells myeloid series.  Myelocytes are                                  predominant cells. Blast   less than 10%

nMegakarryocytes- Increased.

3) NAP score- Markedly reduce

4) Chromosome study –Philadelphia chromosome positive ( 95%  case)

Clinical course of  CML

n1) Chronic phase

n2) Accelarated phase

n3) Blastic phase ( Blast transformation)- Transformation of CML to acute leukaemia) 

INFLAMMATION:http://inflammationofhuman.blogspot.com/