17 Chronic Leukemia

CML

• granulocytes: CML, leukemia since WBC

• leukemia: increased WBC in blood

• myeloproliferative disorder: over proliferation of cells

• nl WBC 10k

• increase in every stage of neutrophils

• RBC low

• number of phases

• chronic: nonspecific phase

• important to distinguish AML from left shift

• must exclude left shift to diagnose CML

• BCL from 9 and ABL from 22

• translocation: BCL-ABL next to each other on 22

• oral pills

CLL

• naive lymphocytes not lymphoblasts

• CD5: T cell marker

• CLL: a confused malignancy, not sure if it wants to be leukemia or lymphoma

• can have large lymph nodes like SLL

• lymphocytes disrupted

• feared complication

• related to CLL

• CLL, leukemia: high WBC

• SLL, lymphoma: swollen lymph nodes with mild lymphocytosis

Hairy Cell

• WBC fill up red pulp so big that obliterates white pulp

• abd pain from splenomegaly