CML is one of the four major categories ofleukemia.
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All leukemias begin in the blood-forming cells in the bone marrow.
This article will discuss the causes, risk factors, and symptoms of CML.
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It will then cover the process of diagnosing and treating CML.
What Are the Causes of CML?
Certain changes in DNA can cause normal bone marrow cells to become leukemia cells.
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People with CML generally havethe Philadelphia chromosome, which contains the abnormal BCR-ABL gene.
The BCR-ABL gene causes white blood cells to grow in an abnormal, uncontrolled way, leading to leukemia.
Who Gets Chronic Myeloid Leukemia?
How Common Is CML?
CML is relatively rare.
About one in 526 people in the U.S. will get CML at some point in their lifetime.
What Are the Symptoms of CML?
Because CML is a slow-growing cancer, many people do not havesymptomsat the time of diagnosis.
Some with leukemia do not have any symptoms at all and arediagnosedbased on abnormalities detected with routine blood work.
CML may cause symptoms as it progresses with time.
The spleen normally stores blood cells and destroys old blood cells.
In CML, the spleen may become enlarged because of all the extra white blood cells occupying the organ.
Along with an enlarged spleen size, lab, gene, and imaging tests can accurately detect CML.
These are often described as blasts (immature WBCs) based on their appearance.
If your blood tests are consistent with CML, you may need to have a bone marrow aspiration.
Imaging Tests
Diagnostic imaging tests are not needed to diagnose CML.
However, they might be performed as part of the assessment of certain symptoms or to evaluate abdominal swelling.
What Are the Three Stages of CML?
CML can be classified into three different phases.
The phase is based on the number of blasts in your blood and bone marrow.
However, blasts should still make up less than 10% of cells.
Symptoms may include fever, weight loss, decreased appetite, and an enlarged spleen.
There are different sets of criteria used to define the accelerated phase.
It is the third and final stage and has the potential to be life-threatening.
The WHO defines the blast phase as greater than 20% blast cells in the bloodstream or bone marrow.
The definition also includes the presence of blast cells outside of the blood or bone marrow.
People in the same risk group are more likely to respond in a similar way to treatment.
People in the low-risk group generally respond better to treatment.
However, these groupings are tools, not absolute indicators.
How Is CML Treated?
Not every person with CML receives every CML treatment discussed below.
About half of the patients have been able to stop the medications successfully.
People who’ve gone off tyrosine kinase inhibitors can restart the therapy if CML comes back.
Advances in CML treatment have been significant in recent decades, but there is still room for further improvement.
These drugs come in the form of pills that can be swallowed.
Immunotherapy
Interferon is a substance that the immune system naturally makes.
PEG (pegylated) interferon is a long-acting form of interferon.
Interferon comes as a liquid that is injected under the skin or into a muscle with a needle.
Intolerance is when treatment with a drug must be stopped due to severe side effects.
Omacetaxine is given as a liquid that is injected under the skin with a needle.
Other chemotherapy drugs may be injected into a vein or may be given as a pill to swallow.
An allogeneic HCT is a complex treatment and can cause very serious side effects.
It is usually considered as a treatment option for patients younger than 65 years of age.
Clinical Trials: Investigational Therapies
New drugs for the treatment of CML are continuously being investigated.
Clinical trials may be an option for some patients.
People with CML may not experience any symptoms.
With tyrosine kinase inhibitor medications, the disease can often be kept in the chronic phase for years.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
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