Highlights & Basics
- Blast crisis may be discovered incidentally on complete blood count or when assessing patients with symptoms and signs such as fever, fatigue, malaise, weight loss, anemia, thrombocytopenia, or splenomegaly.
- Complete blood count with differential is the initial laboratory test. Cytopenias and the presence of blast cells serve as clues to diagnosis. These should lead to a peripheral blood smear and bone marrow examination.
- Diagnosis is confirmed by the percentage of blast cells in the peripheral blood and/or bone marrow (i.e., ≥20% or ≥30% depending on the criteria used) or the presence of an extramedullary proliferation of blasts.
- Diagnosis of chronic myeloid leukemia (CML) requires the presence of the Philadelphia chromosome (a genetic mutation that results in the oncogenic BCR::ABL1 fusion gene).
- Tyrosine kinase inhibitors are paramount in treatment, often used in combination with chemotherapy. Allogeneic stem cell transplant must follow due to rapid relapse.
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Citations
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