Overview Of Chronic Myelogenous Leukemia
Chronic Myelogenous Leukemia (CML) is a cancer that starts inside the bone marrow. This is the soft tissue in the center of bones that helps form all blood cells.
CML causes uncontrolled growth of immature and mature cells that make a certain type of white blood cell called myeloid cells. The diseased cells build up in the bone marrow and blood.
Commonly Associated With
CML; Chronic myeloid leukemia; CGL; Chronic granulocytic leukemia; Leukemia – chronic granulocytic
Causes Of Chronic Myelogenous Leukemia
The cause of CML is related to an abnormal chromosome called the Philadelphia chromosome.
Radiation exposure can increase the risk of developing CML. Radiation exposure can be from radiation treatments used in the past to treat thyroid cancer or Hodgkin lymphoma or from a nuclear disaster.
It takes many years to develop leukemia from radiation exposure. Most people treated for cancer with radiation do not develop leukemia. And most people with CML have not been exposed to radiation.
CML most often occurs in middle-aged adults and in children.
Symptoms Of Chronic Myelogenous Leukemia
Chronic myelogenous leukemia is grouped into phases:
- Chronic
- Accelerated
- Blast crisis
- The chronic phase can last for months or years. The disease may have few or no symptoms during this time. Most people are diagnosed during this stage when they have blood tests done for other reasons.
The accelerated phase is a more dangerous phase. Leukemia cells grow more quickly. Common symptoms include fever (even without infection), bone pain, and a swollen spleen.
Untreated CML leads to the blast crisis phase. Bleeding and infection may occur due to bone marrow failure.
Other possible symptoms of a blast crisis include:
- Bruising
- Excessive sweating (night sweats)
- Fatigue
- Fever
- Pressure under the lower left ribs from a swollen spleen
- Rash — small pinpoint red marks on the skin (petechiae)
- Weakness
Exams & Tests
A physical examination often reveals a swollen spleen. A complete blood count (CBC) shows an increased number of white blood cells with many immature forms present and an increased number of platelets. These are parts of the blood that help blood clot.
Other tests that may be done include:
- Bone marrow biopsy
- Blood and bone marrow testing for the presence of the Philadelphia chromosome
- Platelet count
Treatment Of Chronic Myelogenous Leukemia
Medicines that target the abnormal protein made by the Philadelphia chromosome are often the first treatment for CML. These medicines can be taken as pills. People treated with these drugs often go into remission quickly and can stay in remission for many years.
Sometimes, chemotherapy is used first to reduce the white blood cell count if it is very high at diagnosis.
The blast crisis phase is very difficult to treat. This is because there is a very high count of immature white blood cells (leukemia cells) that are resistant to treatment.
The only known cure for CML is a bone marrow transplant or stem cell transplant. Most people, though, do not need a transplant because the targeted medicines are successful. Discuss your options with your oncologist.
You and your health care provider may need to manage many other issues or concerns during your leukemia treatment, including:
- Managing your pets during chemotherapy
- Bleeding problems
- Eating enough calories when you are sick
- Swelling and pain in your mouth
- Safe eating during cancer treatment
