ABSTRACT
To identify the clinical indicators of accelerated phase in chronic myeloid leukemia [CML] diagnosed on hematological findings. Design: An observational and prospective study. Place and Duration of Study: The study was conducted at Oncology department of Combined Military Hospital, Rawalpindi and Armed Forces Institute of Pathology from April 1998 to April 1999. Subjects and The study on 51 patients of Philadelphia positive CIVIL in chronic phase and on hydroxyurea therapy were carried out. Clinical features and hematological parameters in the peripheral blood examination were recorded and statistical analysis carried out to document reliable clinical indicators of accelerated phase of CIVIL in reference to those reported in the literature. Clinically, presence of unexplained fever, re-enlargement of spleen after successful regression with hydroxyurea therapy, and bleeding diathesis were found to be statistically significant pointers of progression into accelerated phase of CML. In the hematological features, with the exception of peripheral basophilia, the findings in the peripheral blood were consistent with those reported in the literature. It is concluded that the occurrences of the forementioned clinical features in the follow-up of chronic myeloid leukemia patients herald the accelerated phase of the disease