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Chronic Myelogenous Leukemia Staging 

  • Author: Sandy D Kotiah, MD; Chief Editor: Emmanuel C Besa, MD  more...
 
Updated: Dec 30, 2015
 
 

Phases of Chronic Myelogenous Leukemia

The 3 phases of chronic myelogenous leukemia (CML), as defined by the World Health Organization (WHO),[1, 2] are listed below.

Table. Phases of Chronic Myelogenous (Open Table in a new window)

CML phaseWHO definition
Chronic stable phasePeripheral blood blasts fewer than 10% in the blood and bone marrow
Accelerated phaseBlasts 10-19% of white blood cells in peripheral and/or nucleated bone marrow cells ; persistent thrombocytopenia (< 100 × 109/L) unrelated to therapy or persistent thrombocytosis (> 1000 × 109/L) unresponsive to therapy; increasing white blood cells and spleen size unresponsive to therapy; cytogenetic evidence of clonal evolution
Blast crisisPeripheral blood blasts ≥ 20% of peripheral blood white blood cells or nucleated bone marrow cells; extramedullary blast proliferation; and large foci or clusters of blasts on bone marrow biopsy

See Chronic Leukemias: 4 Cancers to Differentiate, a Critical Images slideshow, to help detect chronic leukemias and determine the specific type present.

 
Contributor Information and Disclosures
Author

Sandy D Kotiah, MD Director of the Neuroendocrine Center, Hematology and Medical Oncology, Mercy Medical Center

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Christopher D Braden, DO Hematologist/Oncologist, Chancellor Center for Oncology at Deaconess Hospital

Disclosure: Nothing to disclose.

Chief Editor

Emmanuel C Besa, MD Professor Emeritus, Department of Medicine, Division of Hematologic Malignancies and Hematopoietic Stem Cell Transplantation, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University

Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American Society of Clinical Oncology, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Hematology, New York Academy of Sciences

Disclosure: Nothing to disclose.

References
  1. [Guideline] National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Chronic Myelogenous Leukemia. V 1.2016. Available at http://guidelines.nccn.org/epc-guideline/guideline/id/EBA4F5EF-5A9B-E0B4-C6A4-BFDD8FA8BF78?jumpTo=false#. Accessed: December 30, 2015.

  2. Chronic Myelogenous Leukemia Treatment (PDQ) -Stages of chronic myelogenous leukemia. September 21, 2015 2013. NIH. National Cancer Institute. Available at http://www.cancer.gov/cancertopics/pdq/treatment/CML/Patient/page2. Accessed: December 30, 2015.

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Table. Phases of Chronic Myelogenous
CML phaseWHO definition
Chronic stable phasePeripheral blood blasts fewer than 10% in the blood and bone marrow
Accelerated phaseBlasts 10-19% of white blood cells in peripheral and/or nucleated bone marrow cells ; persistent thrombocytopenia (< 100 × 109/L) unrelated to therapy or persistent thrombocytosis (> 1000 × 109/L) unresponsive to therapy; increasing white blood cells and spleen size unresponsive to therapy; cytogenetic evidence of clonal evolution
Blast crisisPeripheral blood blasts ≥ 20% of peripheral blood white blood cells or nucleated bone marrow cells; extramedullary blast proliferation; and large foci or clusters of blasts on bone marrow biopsy
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