Clinical Features

• Can persist for up to 10 years and is often subclinical

• When symptomatic, features include:

  • Weight loss, fever, night sweats, fatigue

  • Splenomegaly: abdominal discomfort in the left upper quadrant

  • Lymphadenopathy is not typical in CML.

• Erythrocytopenia: anemia

• Neutropenia: infection and fever

• Extreme pleocytosis

  • Infarctions: splenic and myocardial infarctions, retinal vessel occlusion

  • Leukemic priapism

  • Terminal phase: myelofibrosis

• Extreme splenomegaly : palpable in lower left quadrant or pelvic cavity

The blast crisis is the terminal stage of CML.

• Symptoms resemble those of acute leukemia.

• Rapid progression of bone marrow failure → pancytopenia, bone pain

• Severe malaise

• Subtypes :

  • Myeloid blast crisis → AML (⅔ of cases)

  • Lymphoid blast crisis → ALL (⅓ of cases)