题目内容

患者男性，42岁，有慢性粒细胞白血病病史2年，服用马利兰治疗效果较好。近期出现乏力，低热，鼻衄。检查：脾大肋缘下6cm，血红蛋白70g/L，外周血原始粒细胞比例大于20%。应首先考虑的是

A. 急性溶血
B. 骨髓抑制
C. 慢粒急变
D. 脾功能亢进
E. 合并肺结核

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