Clinicohematological Spectrum of Chronic Myeloid Leukemia: A Cross-Sectional Study From a Tertiary Care Hospital in North India.

INTRODUCTION

Myeloproliferative neoplasms (MPNs) are a group of clonal hematopoietic stem cell disorders characterized by proliferation of one or more myeloid lineages in the bone marrow, resulting in an increased number of mature and immature cells in the peripheral blood and bone marrow. Chronic myeloid leukaemia (CML) is one of the commonest clonal myeloproliferative neoplasms encountered in clinical practice. It is characterized by a reciprocal rearrangement and fusion of the BCR genes on chromosome 22 and the ABL gene on chromosome 9.  Materials and methods: A cross-sectional study on the clinicohematological profile of chronic myeloid leukemia patients was conducted over five years in the hematology section of the pathology department in a tertiary care centre in North India. Detailed clinical history and examination, laboratory investigations of all the patients, along with molecular and cytogenetic studies, were noted from the patients' file records and bone marrow request forms. Peripheral blood film (PBF), bone marrow aspiration (BMA), clot section, and bone marrow biopsy slides were studied in detail. Frequencies and proportions were calculated based on all the above parameters, with relevant statistical analysis and final diagnosis were made and classified according to the WHO 2016 classification.

RESULTS

There were a total of 76 patients with CML, out of which 52 (69%) were in the chronic phase, 6 (8%) in the accelerated phase, and 18 (24%) in blast crisis. Leucocytosis with myeloid predominance was seen both on peripheral blood film as well as in bone marrow aspiration and biopsy slides in all of the cases. Cytogenetic studies showed BCR-ABL1 positivity in the majority of the patients (82.8%; n=63).

CONCLUSION

Most of the data available on MPNs is from studies in developed countries. There is only limited literature in India due to a lack of a centralized registry. The present study was an attempt to categorize CML as a group based on symptoms, morphology, and cytogenetics at a tertiary care hospital in a real-world setting.