1. A Case of CML By Dr. P. Arul M 7 Unit Prof. Dr. P. Vijayaraghavan’s unit

12. Peripheral smear

21. Differential diagnosis N N N or Essential thrombocytosis N N or N or Polycythemia vera abn or N or N or or N or Myelofibrosis N N or N CML Red cell morphology Platelets Hematocrit WBC

25. What is failure of treatment Loss of Complete Hematologic Response, loss of complete cytogenetic response + mutation Anytime Less than complete cytogenetic response 18 months after diagnosis Less than partial cytogenetic response 12 months after diagnosis Less than Complete Hematologic Response, no cytogenetic response 6 months after diagnosis No Hematologic Response 3 months after diagnosis Criteria Time

26. Prognosis 0.0413 x eosinophils NA Blood eosinophils 0.20399 when basophils>3% NA Blood basophils 0.0584 x myeloblasts 0.0887 x (myeloblast – 2.10) Blood myeloblast % 1.0956 when platelet count >1500 x 10 9 /L 0.188 x [(platelet /700) 2 - 0.563] Platelet count x 10 9 /L 0.042 x spleen 0.0345 x (spleen–7.51) Spleen 0.666 when age >50 yrs 0.116 x (age-43.4) Age Hasford system Sokal index 781 – 1480 0.8 – 1.2 Intermediate > 1480 > 1.2 High < 780 < 0.8 Low Relapse rate

27. Thank you