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Joseph H. Antin, MD, Discussant

JAMA. 2003;290:1083-1090.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

DR BURNS: Mrs P is a 41-year-old woman with chronic myelogenous leukemia (CML). She previously worked as a hairdresser but has not worked for several months. Mrs P lives with her husband and children. She has commercial insurance.

For a number of years, Mrs P noted that she felt fatigued and had headaches. She sought medical care, but no explanation was found. In June 2002, she went to a new primary care physician and was found to have a white blood cell count of 58 x 10³/µL, hematocrit of 41.4%, and a platelet count of 211 x 10³/µL. There were 51 polys, 2 monocytes, 1 eosinophil, 1 promyelocyte, 13 myelocytes, 14 bands, and 5 metamyelocytes. A bone marrow biopsy was performed and she was found to have a myeloproliferative disorder; cytogenetic testing showed classic Philadelphia chromosome (Ph).

Mrs P was seen . . . [Full Text of this Article]

MRS P, HER VIEW

AT THE CROSSROADS: QUESTIONS FOR DR ANTIN

Epidemiology of CML

Presenting Symptoms

Classification and Diagnosis

Natural History of CML

Prognosis

Laboratory Monitoring

Treatment Options

The Future

Recommendations for Mrs P

QUESTIONS AND DISCUSSION

Author Affiliation: Dr Antin is Chief, Stem Cell Transplantation Program, Department of Medical Oncology, Dana-Farber Cancer Institute and Department of Medicine, Brigham and Women's Hospital. Professor of Medicine, Harvard Medical School.

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