Question

The nurse is caring for a client with chronic myelogenous leukemia (CML) and notes that the client has splenomegaly and an increased basophil count as well as night sweats, bone pain, and a low grade fever. The nurse interprets the symptoms as indicating that the client is in which phase of the clinical course of CML?

a. Chronic
b. Terminal
c. Remissive
d. Accelerated

Answer 1

The client's symptoms, including splenomegaly, increased basophil count, night sweats, bone pain, and a low-grade fever, suggest a progression of chronic myelogenous leukemia (CML) beyond the chronic phase. In CML, there are three main phases:

a. Chronic Phase: This is the initial phase of CML when the disease is relatively stable and often asymptomatic.

b. Accelerated Phase: In this phase, the disease becomes more aggressive and symptoms may worsen. The presence of symptoms like those mentioned in the question suggests the accelerated phase.

c. Terminal Phase (Blast Crisis): This is the most advanced and aggressive phase of CML, characterized by a high number of immature white blood cells (blasts) in the blood and bone marrow.

So, the correct answer is:

d. Accelerated

The symptoms described are indicative of the accelerated phase of CML, where the disease becomes more aggressive and less responsive to treatment.