AP-CML

 Q: Accelerated phase (AP) of Chronic Myeloid Leukemia (CML) should be considered a part of the blast phase (BP) CML? 

A) Yes 

B) No 

Answer: B 

Chronic myeloid leukemia (CML) is a myeloproliferative disorder associated with Philadelphia chromosome. The objective of this question is to highlight the fact that chronic phase (CP) CML, accelerated phase (AP) CML, and blast phase (BP) CML are three distinct scenarios.

All three entities are differentiated on the basis of myeloblast count, percentage of basophils, additional chromosomal abnormalities, and clinical features. Further, AP-CML can be a de novo or a transformation of CP CML - where prognosis and treatments may be different.  Like, CP-CML responds well to treatment with a BCR-ABL1 tyrosine kinase inhibitor (TKI). 

There are three usually followed criteria for AP-CML: 1) World Health Organization (WHO), 2) European LeukemiaNet (ELN) and 3) MD Anderson Cancer Center (MDACC). 

#oncology

References:

1. Mukherjee S, Kalaycio M. Accelerated Phase CML: Outcomes in Newly Diagnosed vs. Progression From Chronic Phase. Curr Hematol Malig Rep. 2016 Apr;11(2):86-93. doi: 10.1007/s11899-016-0304-7. PMID: 26932346. 

2. Aladağ E, Haznedaroğlu İC. Current perspectives for the treatment of chronic myeloid leukemia. Turk J Med Sci. 2019 Feb 11;49(1):1-10. doi: 10.3906/sag-1810-81. PMID: 30761815; PMCID: PMC7350850.