History and exam
Key diagnostic factors
common
presence of risk factors
Risk factors include middle age, male sex, and exposure to ionising radiation.
uncommon
shortness of breath
May occur on exertion.
left upper quadrant discomfort or fullness
epistaxis
Due to thrombocytopenia or abnormal platelet function.
arthralgia
Can occur due to increased uric acid production from extensive cell turnover.
sternal tenderness
Due to bone marrow expansion of the sternum.
Other diagnostic factors
common
weight loss
More likely to occur in accelerated and blast phases.
excessive sweating
More likely to occur in accelerated and blast phases.
Risk factors
strong
age 65 to 74 years
In the US, incidence peaks between the ages of 65 and 74 years.[13]
In the UK, peak incidence is greatest in the 85 to 89 years age group.[15]
Median age at diagnosis in the US is 66 years.[13]
In Southeast Asia, median age at diagnosis is considerably lower.[24][25][26][27] Environmental and demographic factors may contribute to this discrepancy.
weak
ionising radiation exposure
Case series and literature reviews report secondary CML following radiotherapy.[16][28][29]
A positive association exists between cumulative dose of ionising radiation and death caused by CML among nuclear industry workers.[18][30]
An increased incidence of CML has been reported in Japanese atomic bomb survivors; risk appears to be greater with exposure to higher radiation doses.[17]
male sex
CML is more common in males (age-adjusted rate of new cases per 100,000 people [all races] 2.5 males:1.5 females).[13]
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