A 48-year-old woman complains she has had weakness, fatigue, and easy bruisability for 2 months. She had worked as a technician in a nuclear energy plant for 15 years and was involved in an accident during which she was exposed to considerable radiation. Physical examination reveals an enlarged liver and spleen. What disease should you suspect as a likely cause of her condition?

The evidence that whole-body radiation can lead to cancer is incontrovertible and comes from animal experiments and studies of the effects of occupational exposure, radiation therapy for nonneoplastic conditions, the diagnostic use of certain radio-isotopes, and the atom bomb explosions. Some survivors of the atom bomb explosions and patients subjected to spinal radiation later developed chronic myelogenous leukemia. Although the other choices may lead to hepatosplenomegaly, they are not linked to acute radiation exposure.Diagnosis: Chronic myelogenous leukemia