Case 127 – update 1

Our 31 year old patient has repeat bloods including a few extra. FBC confirms leucocytosis with WCC 38, and basophilia 3.8. Platelets are normal. U&Es and LFTs are normal. No organomegaly on clinical exam.

Cytogenetics confirms the Ph chromosome t(9;22) and RT-PCR demonstrates BCR-ABL1 to ABL1 transcript ratio as 56%

This confirms a diagnosis of CML in chronic phase

On further questioning, this 31 year old female patient has no relevant PMH. She has a FH of familial hypercholesterolaemia but maintains regular exercise, good diet and doesn’t smoke. She works as a primary school teacher, has been married for 2 years and has no children, but is planning a family in the near future.

How would you explain the disease/prognosis to this young patient? What would be the options for 1st line treatment?

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