The Blast Crisis phase of chronic myelogenous leukemia is the most serious and life threatening phase of this type of cancer. In the blast phase, the leukemia cells become more abnormal and the disease is no longer driven solely by the Philadelphia chromosome. By the time someone is in the blast phase they have accumulated a number of other genetic abnormalities besides the BCR-ABL. Remember that I told you that these are smart little suckers and that is why we must be diligent in taking our medications just the way that they are prescribed.
All of these abnormal cells now crowd out the healthy cells and the number of red cells and platelets can drastically drop. The blast cells increase to at least 20% in the blood and marrow. The leukemia begins to act more like an acute leukemia with blood counts getting higher and symptoms appearing and becoming more severe. Most often the leukemia cells in the blast phase act like cells of acute myeloid leukemia (AML), but are often resistant to the chemotherapy drugs that are normally used to treat AML.
The only real treatment for a person in blast crisis is a bone marrow transplant. Your doctors will no doubt attempt to get your disease back into the chronic phase before doing a bone marrow transplant, but even if you respond well to chemotherapy and/or oral tyrosine kinase inhibitors, this response to the disease is likely short-lived. The only “real” hope for a person in blast crisis is a stem cell transplant.
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