Chronic phase x 3-5y, then accelerated phase with blast crisis→ infection, bleeding
Physical Exam Findings
Often splenomegaly
Tests
CBC remarkable for elevated WBCs (otherwise unexplained)
Typically left-shifted differential, with immature myeloid cells--> metamyelocytes, myelocytes, promyelocytes, and sometimes blasts; also eosinophils and basophils; lymphocytes low
Often platelets elevated
Bone marrow bx with hypercellularity (myeloid precursor predominance); cytogenetic studies + for Philadelphia Chromosome (9:22 translocation)
Reverse transcriptase Polymerase Chain Reaction (RT-PCR) + for Bcr-Abl fusion mRNA transcript in serum