CHRONIC MYELOBLASTIC

LEUKEMIA
 1. Epidemiology and Etiology
• Epidemiology
- 15-20% of leukemia and chronic leukemia is
most often found in Indonesia.
- The incidence in western countries: 1 to 1.4 /
100.000/years
- Often about middle age with a peak age of 40-
50 years.
• Etiology
- Radiation
- Leukemogenik: chemicals affect the frequency
of leukemia. Such as: Benzene
- Hereditary: down syndrome
- Virus infection: retrovirus, HTLV-1
 2. Pathogenesis
• BCR-ABL gene on the Philadelphia
chromosome (Ph) causes excessive
proliferation of pluripotent stem cells in
hematopoiesis system.
• Last a long time due to the age of cell
leukemia BCR-ABL gene are anti-apoptotic.
• So urgent hematopoiesis system due to the
formation of abnormal clones
 3. Clinical Manifestations
• CHRONIC PHASE
- Asymptomatic
- Hiperkatabolik symptoms: weight loss,
weakness, anorexia, and night sweats.
- Spelomegali
- Symptoms of gout, impaired vision
• ACCELERATED PHASE
- Fever, fatigue, bone pain (sternum) is getting
progressively
- Leukocytosis
- Platelets decreased
- Promielosit> 30%
 4. Basic Diagnosis Work
• Anamnesis
= Family history, when perceived symptoms,
exposure to / have predisposing factors.
• Physical examination
= Examination of organ enlargement