Blast crisis

Blast crisis

Blast crisis is the final phase in the evolution of CML,.

In this phase CML behaves like an acute leukemia,

• rapid progression
• short survival.

	BLAST CRISIS – DIAGNOSIS	Any of the following present in CML
1		20% blasts in the blood or bone marrow
2		Extramedullary proliferation of blasts

Imatinib	Useful in Blast crisis of CML
	inhibitor targeted at the BCR-ABL tyrosine kinase
	BCR-ABL expression can be reduced by imatinib to very low or nondetectable levels
	Median survival in chronic phase is estimated at a median of 25 to 30 years.
	BC has been reduced to 1% to 1.5% per year

Chronic myelogenous leukemia

Imatinib – inhibitor targeted at the BCR-ABL tyrosine kinase

Imatinib – has fundamentally changed treatment of CML.

BCR-ABL expression can be reduced by imatinib to very low or nondetectable levels in the majority of patients.

Median survival in chronic phase is estimated at a median of 25 to 30 years.

Progress to advanced phase CML or BC has been reduced to 1% to 1.5% per year

	Blast Crisis Symptoms
1	night sweats
2	weight loss
3	fever
4	bone pain
5	symptoms of anemia

Blast crisis is associated with – additional cytogenetic aberrations (ACAs) in addition to the Philadelphia (Ph)–chromosome.

	Blast crisis is associated with – additional cytogenetic aberrations with Philadelphia (Ph)–chromosome Most frequent are the so called “major route” ACA
1	Trisomy 8
2	Additional Ph-chromosome
3	Isochromosome (17q)
4	Trisomy 19)

which are nonrandom and considered relevant for the pathogenesis of BC