blast crisis


Also found in: Dictionary, Thesaurus, Legal, Encyclopedia.
Related to blast crisis: AML

crisis

 [kri´sis] (pl. cri´ses) (L.)
1. the turning point of a disease for better or worse; especially a sudden change, usually for the better, in the course of an acute disease.
2. a sudden paroxysmal intensification of symptoms in the course of a disease.
addisonian crisis (adrenal crisis) the symptoms accompanying an acute onset or worsening of addison's disease: anorexia, vomiting, abdominal pain, apathy, confusion, extreme weakness, and hypotension; if untreated these progress to shock and then death.
aplastic crisis a sickle cell crisis in which there is temporary bone marrow aplasia.
blast crisis a sudden, severe change in the course of chronic granulocytic leukemia, characterized by an increased number of blasts, i.e., myeloblasts or lymphoblasts.
catathymic crisis an isolated, nonrepetitive act of violence that develops as a result of intolerable tension.
celiac crisis an attack of severe watery diarrhea and vomiting producing dehydration and acidosis, sometimes occurring in infants with celiac disease.
developmental crisis maturational crisis.
hemolytic crisis an uncommon sickle cell crisis in which there is acute red blood cell destruction with jaundice.
hypertensive crisis dangerously high blood pressure of acute onset.
identity crisis a period in the psychosocial development of an individual, usually occurring during adolescence, manifested by a loss of the sense of the sameness and historical continuity of one's self, confusion over values, or an inability to accept the role the individual perceives as being expected by society.
life crisis a period of disorganization that occurs when a person meets an obstacle to an important life goal, such as the sudden death of a family member, a difficult family conflict, an incident of domestic violence (spouse or child abuse), a serious accident, loss of a limb, loss of a job, or rape or attempted rape.
maturational crisis a life crisis in which usual coping mechanisms are inadequate in dealing with a stress common to a particular stage in the life cycle or with stress caused by a transition from one stage to another. Called also developmental crisis.
myasthenic crisis the sudden development of dyspnea requiring respiratory support in myasthenia gravis; the crisis is usually transient, lasting several days, and accompanied by fever.
oculogyric crisis a symptom of an acute dystonic reaction in which the person demonstrates a fixed gaze, usually upward; also, the uncontrollable rolling upwards of the eye. It can be a result of encephalitis or a reaction to antipsychotic medications.
salt-losing crisis see salt-losing crisis.
sickle cell crisis see sickle cell crisis.
tabetic crisis a painful paroxysm occurring in tabes dorsalis.
thyroid crisis (thyrotoxic crisis) see thyroid crisis.
vaso-occlusive crisis a sickle cell crisis in which there is severe pain due to infarctions in the bones, joints, lungs, liver, spleen, kidney, eye, or central nervous system.

blast cri·sis

a sudden alteration in the status of a patient with leukemia in which the peripheral blood cells are almost exclusively blast cells of the type characteristic of leukemia; usually accompanied by a decrease in numbers of other formed elements of the blood, fever, and rapid clinical deterioration.
The abrupt conversion of a chronic, relatively indolent leukemia, usually CML, into an acute decompensated, accelerated phase, with a marked—30+% of WBCs—increased proportion of blasts and number of lymphocytes or myelocytes in circulation and bone marrow
Lab Leukocytosis, thrombocytosis or thrombocytopenia, anemia
Management Response to blast crises is usually short-lived; myeloblast transformations are commonly treated with hydroxyurea; one-fourth respond to prednisone with vincristine

blast crisis

Blast phase, blast transformation Oncology The abrupt conversion of a chronic, relatively indolent leukemia usually CML into an acute decompensated, accelerated phase, with a marked–30+% of WBCs—↑ proportion of blasts and number of lymphocytes or myelocytes in circulation and BM Clinical Lymphadenopathy, hepatosplenomegaly, spleen and bone pain, fever, thrombosis Lab Leukocytosis, thrombocytosis or thrombocytopenia, anemia Management Response to BCs is usually short-lived; myeloblast transformations are commonly treated with hydroxyurea;14 respond to prednisone with vincristine. Cf Blast transformation, Relapse.

Blast crisis

Stage of chronic myelogenous leukemia where large quantities of immature cells are produced by the marrow and is not responsive to treatment.
References in periodicals archive ?
The reported clinical features in cases of T-cell blast crisis include B symptoms and lymphadenopathy; however, many patients are diagnosed due to abnormal blood work results.
Deepak Kumar, "Central nervous system blast crisis in chronic myeloid leukemia on imatinib mesylate therapy: Report of two cases," Indian Journal of Hematology and Blood Transfusion, vol.
Latagliata et al., "Sudden blast crisis in patients with Philadelphia chromosome-positive chronic myeloid leukemia who achieved complete cytogenetic remission after imatinib therapy," Cancer, vol.
Imatinib combined with mitoxantrone/etoposide and cytarabine is an effective induction therapy for patients with chronic myeloid leukemia in myeloid blast crisis. Cancer, 109(8), 1543-1549.
[14] Reported that frequency of chronic phase (CP), accelerated phases (AP) and blast crisis (BC) were 77.8%, 15.5% and 6.7% respectively were observed in among the 45 patients suffering from CML with their mean age 37.9 yrs, and male: female ratio of 2.2:1 while Clinico hematological features were Anemia and massive splenomegally, hemoglobin 9.94 g/dl.
Soupir et al3 performed a multi-institutional retrospective analysis of cases of Ph+ AMLs and CML in blast crisis and showed that Ph+ AMLs differed from CML in blast crisis by different clinical pictures (no splenomegaly nor basophilia in Ph+ AML), bone marrow morphology (lower cellularity and myeloid to erythroid ratio in Ph+ AML), cytogenetic findings (characteristic other chromosomal abnormalities usually found in CML were not seen in Ph+ AML), and response to chemotherapy (return to normal karyotype was observed in cases of Ph+ AML, whereas persistence of Ph+ was seen in CML); however, the median survival was similar between the 2 groups.
Another study has shown that hedgehog pathway proteins (such as SHH, SMO, and GLI1) and their downstream effectors are upregulated in CML patients in comparison to normal subjects, and the same proteins are higher in blast crisis patient's cells than in chronic phase cells suggesting a key role that the hedge hog pathway might play in CML blastic transformation of CML patients [77].
"Our findings also suggest that maintaining the level of this microRNA might represent a new therapeutic strategy for CML blast crisis patients who do not benefit from targeted agents such as imatinib (Gleevec) and dasatinib (Sprycel)," Perrotti added.
This is probably due to the fact that GS could indicate the progression of chronic leukemia to a blast crisis, characterized by an increased number of immature blood cells in the peripheral blood or bone marrow (Ferri, 2007).
Imatinib mesylate, an inhibitor of Bcr-Abl tyrosine kinases, has revolutionized the treatment of chronic myelogenous leukemia (CML), showing marked improvements in survival in all three phases of the disease: chronic, accelerated, and blast crisis (see Figure 1).
Oliver Ottman, of the Johann Wolfgang Goethe Universitat in Frankfurt-am-Main, Germany, and his colleagues conducted an open-label, phase II study to evaluate the efficacy of nilotinib in patients with imatinib-resistant or -intolerant CML in blast crisis (CML-BC) or relapsed/refractory Ph+ ALL.
"So far in humans, it appears that only CML cases that progress to lymphoid blast crisis (a marked increase in immature cells) or patients with Philadelphia chromosome-positive ALL are at risk for CNS leukemia," he said.