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Chronic Leukemias: CML and CLL

Chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL) are vital topics for FMGE, NEET PG, and USMLE Step 1 exam preparation, shedding light on hematologic malignancies. CML is characterized by the uncontrolled proliferation of myeloid lineage cells, primarily granulocytes, resulting from the Philadelphia chromosome (Ph chromosome) translocation, leading to the formation of the BCRABL fusion gene. ⚠ This fusion gene encodes a constitutively active tyrosine kinase, driving malignant cell proliferation. Clinical manifestations of CML may include fatigue, splenomegaly, and leukocytosis with left shift. Treatment modalities encompass tyrosine kinase inhibitors such as imatinib, which target the BCRABL fusion protein, leading to improved outcomes for patients. On the other hand, CLL involves the proliferation of mature B lymphocytes, characterized by the accumulation of small, maturelooking lymphocytes in the blood, bone marrow, and lymphoid tissues. Clinical features may include lymphadenopathy, hepatosplenomegaly, and cytopenias. Treatment strategies for CLL vary based on disease stage and patient characteristics, ranging from watchful waiting to chemotherapy and targeted therapies such as Bcell receptor signaling inhibitors. Understanding the pathogenesis, clinical manifestations, and therapeutic approaches to CML and CLL is essential for medical practitioners aiming to excel in the field of hematology and oncology. Let's unravel the complexities of these chronic leukemias and pave the way toward comprehensive medical knowledge!

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