question: Q:A 60-year-old man presents to his physician as part of his routine annual medical check-up. He has no specific complaints but mentions that he has often experienced fatigue over the past few months. His past medical history is noncontributory. On physical examination, his temperature is 37.2°C (98.8°F), pulse rate is 84/min, blood pressure is 130/86 mm Hg, and respiratory rate is 18/min. On general examination, mild pallor is present. Palpation of the abdomen reveals splenomegaly, which extends 6.35 cm (2.5 in) below the left costal margin. There is no hepatomegaly. Laboratory studies show the following values:
  Hemoglobin 9.7 g/dL
  Total leukocyte count 30,000/mm3
  Granulocytes 83%
  Lymphocytes 10%
  Eosinophils 5%
  Basophils 1%
  Monocytes 1%
  Platelet count 700,000/mm3
  The physician orders a bone marrow biopsy analysis of hematopoietic cells. The report shows the presence of a t(9;22)(q34; q11) translocation. Which of the following is the most likely diagnosis?? 
  {'A': 'Chronic myeloid leukemia', 'B': 'Chronic myelomonocytic leukemia', 'C': 'Chronic neutrophilic leukemia', 'D': 'Transient myeloproliferative disorder', 'E': 'Myelodysplastic syndrome/myeloproliferative neoplasm, unclassifiable'},