Introduction: Chronic Myeloid Leukaemia (CML) is a myeloproliferative neoplasm characterised by uncontrolled proliferation of white blood cells and its precursors. At diagnosis, various risk scoring systems have been formulated for risk stratification. In 2016, European Treatment Outcome Study (EUTOS) Long Term Survival (ELTS) score has been formulated most recently. This score was recommended by European LeukaemiaNet in 2020. Objective: The objective of the study was to estimate the frequency of high-risk patients among Chronic Myeloid Leukaemia patients in chronic phase using ELTS scoring system. Materials and Methods: This observational study was conducted among patients at Bangabandhu Sheikh Mujib Medical University (BSMMU) between September 2020 and October 2021. A total of fifty chronic myeloid leukaemia patients were enrolled using purposive sampling technique. Clinical information and haematological parameters were recorded. Bone marrow study was conducted to confirm phase of the disease. ELTS risk score was calculated, and risk stratification was done. Chi-square test was done to find out statistical association between variables. Results: Among study participants, 14% were identified as high-risk cases using ELTS score. 40% of patients were intermediate-risk and 46% were low-risk disease. Presence of hepatomegaly or splenomegaly were significantly more common among high-risk patients. Significantly increased eosinophil and blast percentages and significantly lower haemoglobin level were found in high-risk patients. Conclusion: A fair proportion of the CML patients were identified as high-risk patients. Hepatomegaly, splenomegaly, lower haemoglobin, higher eosinophil and higher blast percentages were identified to be independently associated with higher risk stratification of patients.

Here is a case report of a 62-year-old female who presented to our hospital with complaints of abdominal pain, unresolving severe anemia, bleeding per rectum with history of multiple blood transfusions at outside hospital. On initial investigations, the findings directed towards case of hemolytic anemia. The cause of hemolytic anemia was still unknown even after extensive clinical and laboratory investigations. Bone marrow biopsy was done, which revealed metastatic adenocarcinoma and diagnosis of cancer-related microangiopathic haemolytic anaemia (CR-MAHA) was established. Endoscopic biopsy was done from gastric growth which revealed gastric adenocarcinoma and final diagnosis of microangiopathic hemolytic anemia secondary to gastric adenocarcinoma was made. The patient’s haematological parameters improved with chemotherapy directed against the gastric adenocarcinoma. Our case supports the findings of various literature which indicates that the gastric cancer-associated MAHA responds well to the treatment with chemotherapy for primary carcinoma.