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Staging for Chronic Myelogenous Leukemia

Because leukemia starts in the bone marrow and often has spread to other organs by the time it is detected, there is no need for traditional staging. All leukemias are classified according to their genotypes, or their unique chromosomal arrangements, which also enables the physicians to determine risk factors.

Staging for Chronic Myelogenous Leukemia (CML)

CML is divided into 3 groups that help predict outlook. Doctors call these groups phases instead of stages. The phases are based mainly on the number of immature white blood cells – myeloblasts (“blasts”) — that are seen in the blood or bone marrow.

Chronic Phase
– Patients in this phase typically have less than 10% blasts in their blood or bone marrow samples.
– These patients usually have fairly mild symptoms (if any) and usually respond to standard treatments.

Accelerated Phase
Patients are considered to be in accelerated phase if any of the following are true:
– The bone marrow or blood samples have more than 10% but fewer that 20% blasts.
– High blood basophil count (basophils making up at least 20% of the white blood cells).
– Increased white blood cell counts that do not go down with treatment
very high or very low platelet counts that are not caused by treatment
new chromosome changes in the leukemia cells.

Blast Phase
– Bone marrow and/or blood samples from a patient in this phase have more than 20% blasts.
– The blast cells often spread to tissues and organs beyond the bone marrow. These patients often have fever, poor appetite, and weight loss.

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