Diagnostic criteria: accelerated phase of chronic myelogenous leukemia

MD Anderson*	Sokal et al^¶	WHO^Δ
PB blasts ≥15% PB blasts + pro ≥30%	PB or BM blasts ≥5%	PB or BM blasts 10 to 19%
PB baso ≥20%	PB basophils ≥20%	PB basophils ≥20%
Platelets <100,000/microL not related to therapy	Thrombocytopenia, not related to therapy	Platelets <100,000/microL, unrelated to therapy
Cytogenetic evolution	Cytogenetic evolution	Cytogenetic evolution or additional clonal chromosomal abnormalities in Ph+ cells at diagnosis that include "major route" abnormalities, complex karyotype, or abnormalities of 3q26.2
	Platelets >1 million/microL despite adequate therapy	Platelets >1,000,000/microL unresponsive to therapy
	Marrow collagen fibrosis
	Anemia, unrelated to Rx
	Progressive splenomegaly	Progressive splenomegaly and increasing WBC unresponsive to therapy
	WBC doubling time <5 days
	Unexplained fever
	Pelger-Huett-like neutrophils, nucleated RBCs, megakaryocyte fragments

Examples of "major route" abnormalities defined by the WHO include second Ph, trisomy 8, isochromosome 17q, and trisomy 19. The WHO includes provisional response-to-tyrosine kinase inhibitor criteria for accelerated phase disease.

WHO: World Health Organization; PB: peripheral blood; BM: bone marrow; pro: promyelocytes; baso: basophils; WBC: white blood cell count; RBC: red blood cells.
* Kantarjian, HM, et al. Cancer 1988; 61:1441.
¶ Sokal, JE, et al. Semin Hematol 1988; 25:49.
Δ Arber, DA, et al. Blood 2016; 127:2391.

For each of the three sets of criteria, the accelerated phase of chronic myelogenous leukemia is diagnosed if one or more of the listed features is present. Adapted from O'Dwyer, ME, et al. Blood 2002; 100:1628.

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Diagnostic criteria: accelerated phase of chronic myelogenous leukemia