Complications of CML

At the time of diagnosis, >80% of patients are in chronic phase, which is asymptomatic in many patients.

If CML is left untreated, the natural progression is rapid and fatal, with a median survival of about 3 to 5 years in patients.

As patient progresses into accelerated phase and blast phase, he/she would experience symptoms that often are secondary to splenomegaly: abdominal fullness, pain from splenic infaraction. The spleen may be so enlarged that it may fill the abdominal cavity and extend into the pelvis. Hepatomegaly is also frequently present. Infection and bleeding, which are not common in the chronic phase, are eventually picked up as the disease progresses.

Leukocytosis is a common feature, up to the excess of 300 x 109 /l. The leukocytes are abnormal, with no or severely reduced content of alkaline phosphatise.

The increased numbers of blast cells >30% in blood and bone marrow, marked anaemia and thrombocytopenia are signs of the acute, terminal phase of the disease. This is when the myeloid cells have eventually lost the ability to differentiate, in which clinical features are very close to those of acute leukaemia.