Diagnosis of Chronic Myeloid Leukaemia

Diagnosis of Chronic Myeloid Leukaemia
Usual peripheral blood findings in chronic myeloid leukaemia at diagnosis
* Raised white blood cell count (30-400 x 109/l). Differential shows:
Granulocytes at all stages of development
Increased numbers of basophils and eosinophils
Blast (primitive) cells (maximum 10%)–never present in the blood of normal people
* Haemoglobin concentration may be reduced; red cell morphology is usually unremarkable; nucleated (immature) red cells may be present
* Platelet count may be raised (300-600 x 109/l)\
The diagnosis of chronic myeloid leukaemia in chronic phase can be made from study of the peripheral blood film, but the marrow is usually examined for confirmation.
Marrow examination shows increased cellularity. The distribution of immature leucocytes resembles that seen in the blood film. Red cell production is relatively reduced. Megakaryocytes, the cells giving rise to platelets, are plentiful but may be smaller than usual.
Cytogenetic study of marrow shows the presence of the Ph chromosome in all dividing cells.
The patient's blood concentrations of urea and electrolytes are usually normal at diagnosis, whereas the lactate dehydrogenase is usually raised. Serum urate concentration may be raised.
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References
http://www.bmj.com/cgi/content/full/314/7081/657