Chronic Phase

Approximately 85% of patients with CML are diagnosed in the chronic phase.6 A presumptive diagnosis can be established based on a Giemsa-stained peripheral blood or bone marrow aspirate. The peripheral blood demonstrates variable degrees of leukocytosis with a striking left shift in the white blood cell differential, basophilia, and less frequently, eosinophilia. Thrombocytosis is also common as is a moderate degree of anemia (Table 17.1).7 The morphology of the peripheral blood cells is normal; dysplasia is not a typical feature of CML and points to alternative diagnoses (see below). In the bone marrow, cellularity is increased with a predominance of granulopoiesis over erythropoiesis. Basophils and eosinophils may be increased, usually in proportion to their numbers in

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