PAPER 2026 FULL QUESTIONS AND
CORRECT ANSWERS
◉ case study 4 what other conditions could be considered.
Answer: Chronic neutrophilic leukemia (CNL) and atypical CML
◉ case study 4 why include leukemoid reaction.
Answer: Because there is marked leukocytosis with a left shift
◉ case study 4 why suspect CML.
Answer: Because of very high WBC, basophilia, and many immature
myeloid cells
◉ case study 4 key features suggesting CML.
Answer: Leukocytosis, basophilia, left shift, and splenomegaly
◉ case study 4 what test confirms the diagnosis.
Answer: BCR-ABL1 testing by PCR or FISH
◉ case study 4 what is the hallmark genetic finding.
, Answer: t(9;22) Philadelphia chromosome
◉ case study 4 what does the bone marrow show.
Answer: Hypercellular marrow with increased granulocytes
◉ case study 4 what is the most likely diagnosis.
Answer: Chronic myeloid leukemia (CML), BCR-ABL1 positive
◉ case study 4 why is CML the most likely diagnosis.
Answer: Extremely high WBC with basophilia, myelocytes, and
positive Philadelphia chromosome
◉ case study 4 how is CML treated.
Answer: With tyrosine kinase inhibitors (TKIs)
◉ case study 4 example of treatment.
Answer: Imatinib
◉ case study 4 how is treatment monitored.
Answer: By measuring BCR-ABL1 levels with PCR
◉ case study 4 what is the treatment goal.