78 years old lady went to see her GP with increasing headache, initial management with reassurance and pain control flailed to control her diffuse moderate headache prompted her GP to check her bloods

All the other systems examinations were unremarkable

BLOOD TESTS

HB 120

WCC560

PLT 430 Norma (N 150-450)

Basophilia and eosinophilia noted

mainly neutrophils and myelocytes on film

Her biochemistry all are within normal range

Bloods film

Reviewing the Film by consultant haematologist suggested the diagnosis of chronic myeloid leukaemia in chronic phase

She was brought in to the hospital and had emergency assessment and investigations including bone marrow test

A final diagnosis of CML  (Chronic myeloid leukaemia) in chronic phase were made and she was commenced on Hydroxycarbamide and Imatinb with allopurionl

Learning pint

CML is a curable condition

prompt assessment is necessary to exclude high count bloods for Hyperleckocytsosis and also to exclude Acute leukaemia

Prompt discussion with consultant haematologist is they key for the management of this patients group