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Contempo Updates
August 22/29, 2001

Chronic Myelogenous Leukemia

JAMA. 2001;286(8):895-898. doi:10.1001/jama.286.8.895

Chronic myelogenous leukemia (CML) is a disorder of hematopoietic stem cells1 accounting for 15% of adult leukemias. The median age at presentation is between 50 and 60 years; 12% to 30% of patients at diagnosis are older than 60 years.

Chronic myelogenous leukemia classically progresses through 3 phases, becoming more resistant to treatment in each successive phase. The majority of patients present in the chronic phase, which may last 4 to 6 years and is often asymptomatic at diagnosis. In the accelerated phase, symptoms become worse and immature blasts increase in the peripheral blood. The duration of this phase may last as long as a year. The final and fatal blastic phase (>30% blasts in the bone marrow or peripheral blood) has features of an acute leukemia including fever, weight loss, bleeding, and anemia; this phase may last 3 to 6 months.

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