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Chronic myeloid leukaemia — RACP Adult Medicine MCQ

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ModerateHaematologyChronic myeloid leukaemiaRACP Adult Medicine

A 55-year-old man has fatigue, early satiety and splenomegaly. White cell count is 92 x10^9/L with neutrophilia, basophilia and myelocytes. Platelets are 620 x10^9/L. What is the most likely diagnosis?

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Correct answer: D — Chronic myeloid leukaemia

Marked granulocytic leukocytosis with left shift, basophilia and splenomegaly is typical of CML and should prompt BCR-ABL1 testing. CLL is lymphocytic, APL presents as acute leukaemia often with coagulopathy, and essential thrombocythaemia does not explain the full myeloid spectrum. Reactive neutrophilia rarely produces this pattern with basophilia and splenomegaly.

Reference: eviQ haematology resources; AMH