title: "Preleukemic or smoldering" chronic myelogenous leukemia (CML):BCR-ABL1 positive: A brief case report.
abstract: Chronic myelogenous leukemia (CML), in the Chronic Phase (CP), is often suspected as a result of a complete blood count (CBC), which shows increased granulocytes, mostly mature including a peak in myelocytes, increased basophils, and rarely blasts and/or promyelocytes. Morphologic dysplasia is not present. CML is confirmed by detecting the characteristic Philadelphia chromosome (Ph)[t(9;22)(q34;q11.2)] by routine cytogenetics or fluorescent in situ hybridization (FISH) or molecular studies (RT-PCR) for the bcr-abl fusion gene. The most common feature of CML is an elevated WBC count, usually above 25×10(3)/µL, and frequently above 100×10(3)/µL. We report a case of confirmed Ph+CML with a normal CBC detected because of the presence of rare myelocytes and 2% basophils [Fig. 1]. Previous leukocyte counts for the preceding eight years were normal with the exception of one done four months prior to his presentation that showed an abnormal differential with 1% basophils, 2% metamyelocytes and 2% myelocytes.
authors.affiliation: Department of Pathology, Medicine and James P. Wilmot Cancer Institute, Rochester, NY, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Bennett
authors.affiliation: Department of Medicine, Hematology/Oncology Section, Rochester General Hospital, Rochester, NY, USA.
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Dsouza
authors.affiliation: Department of Medicine, Hematology/Oncology Section, Rochester General Hospital, Rochester, NY, USA.
authors.forename: Mehul
authors.initials: M
authors.lastname: Patel
authors.affiliation: Department of Medicine and James P. Wilmot Cancer Institute, Rochester, NY, USA.
authors.forename: Kristen
authors.initials: K
authors.lastname: O'Dwyer
keywords: Chronic myeloid leukemia; Philadelphia chromosome