blast crisis


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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 ?
Imatinib combined with mitoxantrone/etoposide and cytarabine is an effective induction therapy for patients with chronic myeloid leukemia in myeloid blast crisis.
The clinical and morphologic features at the outset did not fit a diagnosis of CML, chronic phase, accelerated phase, or blast crisis, as defined by the World Health Organization blue book (1).
The approval of Gleevec(x) is based on data from three Phase II open- label, single arm studies that showed a major cytogenetic response in patients with advanced stages of CML (21 per cent in the accelerated phase and 14 per cent in myeloid blast crisis), as well as hematologic responses for patients in accelerated phase and myeloid blast crisis (63 per cent and 26 per cent, respectively).
Responses occurred in 55 percent of those with myeloid blast crisis, with four of those patients having their white blood cell counts returned to normal.
Morphologic and immunological features of blasts in blast crisis may be discordant.
Results showed that fewer patients progressed to accelerated phase or blast crisis on Tasigna at 300 mg twice daily (n = 2) and 400 mg twice daily (n = 1) versus Glivec at 400 mg once daily (n = 12) with 18 months of median follow-up, demonstrating a significant improvement in disease control.
3,4) This case represents an example of simultaneous extramedullary and intramedullary CML blast crisis following transplant.
1) Though the skin infiltrate show less than 5% blast and reported in chronic phase of the disease, presence of leukemia cutis strongly suggests that blast crisis is imminent.
Imatinib was approved by the Food and Drug Administration in February 2002 for the treatment of patients with CML in blast crisis, accelerated phase, or in chronic phase after failing to respond to interferon.
5% of Gleevec patients progressed to the accelerated phase or blast crisis, compared with 7% of interferon patients.