In the chronic phase (CP) of CML, the leukemic cells infiltrate the bone marrow, peripheral blood, spleen, and liver. Approximately 20-40% of patients are asymptomatic with CML being discovered during routine blood work that displays a significant leukocytosis and/or thrombocytosis and mild to moderate anemia. Patients always have an enlarged spleen.
In the blastic phase (BP) of CML, other tissues like lymph nodes, skin, bone, or the central nervous system may be involved with the leukemic cells, which is referred to as extramedullary blast proliferation.
Most patients are diagnosed in the chronic phase (CP). They may present with leukocytosis, thrombocytosis, anemia, enlarged spleen, night sweats, and fatigue. Progression to accelerated and blastic phases is the natural course. Such progression takes 2-3 years.
Disease transformation to accelerated and blastic phases is accompanied by worsening symptoms, including symptoms related to anemia, neutropenia, thrombocytopenia, and increased spleen size.
