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Clinical Crossroads
Clinician's Corner
August 27, 2003

A 41-Year-Old Woman With Chronic Myelogenous Leukemia

Author Affiliations

Author Affiliation: Dr Antin is Chief, Stem Cell Transplantation Program, Department of Medical Oncology, Dana-Farber Cancer Institute and Department of Medicine, Brigham and Women's Hospital. Professor of Medicine, Harvard Medical School.


Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor.

JAMA. 2003;290(8):1083-1090. doi:10.1001/jama.290.8.1083

DR BURNS: Mrs P is a 41-year-old woman with chronic myelogenous leukemia (CML). She previously worked as a hairdresser but has not worked for several months. Mrs P lives with her husband and children. She has commercial insurance.

For a number of years, Mrs P noted that she felt fatigued and had headaches. She sought medical care, but no explanation was found. In June 2002, she went to a new primary care physician and was found to have a white blood cell count of 58 × 103/µL, hematocrit of 41.4%, and a platelet count of 211 × 103/µL. There were 51 polys, 2 monocytes, 1 eosinophil, 1 promyelocyte, 13 myelocytes, 14 bands, and 5 metamyelocytes. A bone marrow biopsy was performed and she was found to have a myeloproliferative disorder; cytogenetic testing showed classic Philadelphia chromosome (Ph).

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