CML - Accelerated Phase (AP)

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The page below is a sample from the LabCE course Chronic Myeloid Leukemia (CML). Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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CML - Accelerated Phase (AP)

It is important to distinguish the accelerated phase of CML from the chronic phase. The accelerated phase of CML indicates disease progression with worsening clinical condition and may require additional treatment. The accelerated phase is indicated when one or more of the following criteria are present:
  1. Persistent increase of the WBC count, in spite of therapy
  2. Increased splenomegaly, unresponsive to therapy
  3. Persistent thrombocytosis unresponsive to therapy or thrombocytopenia
  4. Develop additional cytogenetic abnormalities in addition to the t(9;22) - Philadelphia Chromosome
  5. Increased basophil count in the peripheral blood (>20% of total WBC count)
  6. Increase in the blasts number (10 - 19%) in the peripheral blood and/or bone marrow
  7. Bone marrow hypercellularity with possible myeloid dysplasia

A peripheral blood smear with basophils and blast cells as noted by arrows.
A peripheral blood smear with basophilia.