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Chronic Myeloid Leukaemia — RACP Adult Medicine MCQ

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EasyHaematologyChronic Myeloid LeukaemiaRACP Adult Medicine

A 45-year-old man presents with fatigue and splenomegaly. WCC is 85 × 10⁹/L with left shift showing all stages of myeloid maturation (myelocytes, metamyelocytes, bands). Basophilia is present. Philadelphia chromosome (BCR-ABL1) is positive. What is the most likely diagnosis?

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Correct answer: B — Chronic myeloid leukaemia

Marked leukocytosis with full myeloid maturation spectrum, basophilia, splenomegaly, and BCR-ABL1 positivity (Philadelphia chromosome) is diagnostic of CML in chronic phase. First-line treatment is a tyrosine kinase inhibitor (imatinib, dasatinib, or nilotinib). Monitoring via BCR-ABL1 transcript quantification every 3 months.

Reference: WHO – 2022 – Myeloid Neoplasm Classification; ELN 2024 CML Guidelines