Haem: Chronic Myeloid Leukaemia: Free MSRA Podcast

🎧 MSRA Podcast: Chronic Myeloid Leukaemia (CML) – Fast Facts, High-Yield Review 🎧It’s time to master CML for your MSRA, with a high-yield deep dive into this classic haematology exam topic. Listen in as we break down everything you need to know for the exam—and for clinical practice.🧬 Definition:Chronic Myeloid Leukaemia (CML) is a myeloproliferative neoplasm, marked by uncontrolled proliferation of myeloid white blood cells due to the BCR-ABL1 fusion gene (the Philadelphia chromosome).⚡ Causes / Risk Factors:Philadelphia chromosome (t(9;22)(q34;q11) reciprocal translocation → BCR-ABL1 fusion gene)Most cases are sporadic; high-dose ionising radiation is a rare risk factorOlder age (median diagnosis: 60–72 years), slightly more common in males🧪 Pathophysiology:BCR-ABL1 → abnormal tyrosine kinase protein → drives uncontrolled myeloid cell growthInhibits apoptosis (old cells don’t die) + accelerates cell division🩺 Clinical Features:Often insidious onset—fatigue, weight loss, night sweats, low-grade feverSplenomegaly (abdominal fullness, LUQ pain)Anaemia (pallor, SOB), easy bruising, recurrent infectionsMay be incidentally picked up on a routine FBC🧠 Phases:Chronic phase (most diagnosed here)Accelerated phaseBlast crisis (transformation to acute leukaemia, high mortality)🔎 Diagnosis:FBC: High WCC (all myeloid lines), thrombocytosisPeripheral blood film: Immature granulocytesLow LAP scoreBone marrow biopsy: Confirms diagnosis, assesses blast %Cytogenetics/FISH/PCR: Philadelphia chromosome and BCR-ABL1PCR for ongoing monitoring🩹 Management:First-line: Tyrosine kinase inhibitors (TKIs) — imatinib, nilotinib, dasatinibHigher generations or stem cell transplant for resistant/advanced casesNICE: Imatinib standard first line, others as alternativesLifelong treatment/monitoring📈 Prognosis:Transformed by TKIs: 5-year survival >90% (was ~33% pre-TKIs)Best outcomes if diagnosed in chronic phase, good response to TKIComplications: Progression to blast crisis, TKI side effects (cytopenias, GI, cardiovascular), psychological impact🧠 Memory Aids:"FEWBANDS": Fatigue, Easy bruising, Weight loss, Bone pain, Abdominal fullness, Night sweats, Dyspnoea (SOB)"9 to 5, switch at 22": Chromosome 9 and 22 swap → Philadelphia chromosome• 📖 Revision Notes:https://www.passthemsra.com/topic/chronic-myeloid-leukaemia-revision-notes/• 🃏 Flashcards:https://www.passthemsra.com/topic/chronic-myeloid-leukaemia-flashcards/• ❓ Accordion Q&A Notes:https://www.passthemsra.com/topic/chronic-myeloid-leukaemia-accordion-qa-notes/• 🏆 Rapid Fire Quiz:https://www.passthemsra.com/topic/chronic-myeloid-leukaemia-rapid-quiz/• 📝 Online Quiz:https://www.passthemsra.com/quizzes/chronic-myeloid-leukaemia/#MSRA #CML #ChronicMyeloidLeukaemia #Haematology #MSRARevision #MSRAFlashcards #MSRAQuiz #PassTheMSRAExam Pearl:Always think CML in an older adult with a high WCC, splenomegaly, and fatigue—especially if the Philadelphia chromosome is positive!🗝️ Key Learning Points🔗 CML Revision Resources for the MSRA