Chronic Myeloid/Granulocytic Leukemia (CML/CGL)
CML/CGL is a stem cell malignancy affecting all cells of the marrow, including granulocytes, erythroid cells, megakaryocytes, and B lymphoid cells. A high white blood cell count with immature and mature granulocytes is a characteristic feature. Thrombocytosis, anemia, and splenomegaly are often present. Initially symptoms may be mild, but without aggressive intervention (bone marrow transplant), the disease ends in terminal acute leukemia (blast crisis or blast transformation) with replacement of marrow by myeloblasts in approximately two-thirds of cases, or lymphoblasts in approximately one-third of cases. Transformation from the chronic phase to an accelerated phase may be identified by myelofibrosis, increased basophilia, marked anemia, thrombocytopenia, or karyotypic evolution. CML can be seen at any age but is more common in adults.
| t(9:22)(q34;q11.2) | primary abnormality |
| +8 | secondary change |
| +der(22)t(9;22) | secondary change, (extra Philadelphia chromosome) |
| i(17q) | secondary change |
Chronic Lymphocytic Leukemia (CLL)
CLL is an indolent malignancy of small lymphocytes (nearly always B cells) with blood and bone marrow involvement. The leukemia cells also infiltrate lymph nodes (producing a picture indistinguishable from small lymphocytic lymphoma), the spleen, and other organs. CLL occurs in older age groups.
| chromosome 1 abnormalities | multiple myeloma |
| +12 | B-CLL |
| 14q32 rearrangements | hairy cell leukemia, Sezary’s syndrome, B-CLL, B-cell prolymphocytic leukemia (B-PLL), multiple myeloma |
| del(6q) | hairy cell leukemia, Sezary’s synd., B-CLL |
| inv(14)(q11q32) | T-CLL |
| t(9;14)(p13;q32) | CLL, multiple myeloma |
| t(11;14)(q13;q32) | B-PLL, multiple myeloma, B-CLL |
| t(14;14)(q11;q32) | T-lineage, adult T-Cell leukemia (ATL) |
| t(14;16)(q32;q23) | multiple myeloma |
| t(14;18)(q32;q21) | B-CLL |
| t(14;19)(q32;q13.3) | B-CLL |