Clinical Case Discussion Forum

To share and enhance best practice management of CML, experts and interested clinicians can discuss difficult or interesting CML cases here. Physicians submit a brief history of the patient and the case for discussion using this forum.

Query blast crisis?

Topic Query blast crisis? was created by Dr Saurabh Bhave
Dr Saurabh Bhave India 07:04 24 April 2018

We have a young male with muscle lesion which on biopsy is CML.
He is CML in CP on BM studies.
Cytogenetics: no other abnormalities other than PH chromosome

Is extramedullary CML (without any increase in blasts) be considered as blast crisis?

Regards
Saurabh

Reply by Professor Giuseppe Saglio on topic Query blast crisis?
Professor Giuseppe Saglio Italy 07:27 25 April 2018

To answer this question I have to go back to the opinion of John Goldman (as well as of other experts); extra-medullary CML has to be considered a progression and transformation of CML similar to blast crisis, in particular if the patient was already in TKI therapy. Is this the case?
Yours, Beppe Saglio

Reply by Dr Jeff Lipton on topic Query blast crisis?
Dr Jeff Lipton Canada 07:27 25 April 2018

Agree with Beppe. If this is extramedullary disease, it should be considered like blast crisis. Would consider radiating the lesion and if otherwise responding to TKI, go to allografting in a young person

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