NCCN Guidelines for Patients® | Chronic Myelogenous Leukemia - page 24

24
NCCN Guidelines for Patients
®
: Chronic Myelogenous Leukemia
Version 1.2014
3.3 Blast phase
The blast phase is the final phase of CML progression.
Also referred to as “blast crisis,” CML in this phase can
be life-threatening. There are two criteria groups that
may be used to define blast phase. See Table 3. In this
phase, the number of blast cells in the peripheral blood
and/or bone marrow is very high. Another defining feature
of blast phase is that the blast cells have spread outside
the blood and/or bone marrow into other tissues. CML
in the blast phase may cause more symptoms such as
infections, bleeding, abdominal pain, and bone pain.
In this phase, the leukemia cells become more abnormal.
CML in blast phase often acts similar to acute leukemia.
Acute leukemia is a type of leukemia that grows and
progresses rapidly, whereas chronic leukemia progresses
slowly over months or years. In blast phase, the leukemia
cells may be more similar to AML (
a
cute
m
yeloid
l
eukemia) or more similar to ALL (
a
cute
l
ymphoblastic
l
eukemia). AML causes too many immature white blood
cells called myeloblasts to be made. ALL results in too
many immature white blood cells called lymphoblasts.
Table 3. Criteria for blast phase
World Health Organization
1
International Bone Marrow Transplant Registry
2
≥20% blasts in peripheral blood or bone marrow
≥30% blasts in peripheral blood or bone marrow
Blasts found outside of blood or bone marrow
Blasts found outside of blood or bone marrow
Large groups of blasts found in bone marrow
1 Adapted from Swerdlow SH, Campo E, Harris NL, et al. (Eds.):
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues.
Lyon,
France: IARC Press; 2008.
2 Druker BJ. Chronic Myelogenous Leukemia In: DeVita VT, Lawrence TS, Rosenburg SA, eds. DeVita,
Hellman, and Rosenberg’s Cancer:
Principles & Practice of Oncology.
Vol 2 (ed 8): Lippincott, Williams and Wilkins; 2007:2267–2304.
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