Chronic myelogenous leukemia (CML) is a cancer of the blood and bone marrow. The bone marrow makes abnormal blood cells including: Myeloblasts—a type of white blood cell, fights infectionRed blood cells (RBCs)—carry oxygenPlatelets—makes blood clot, stops bleeding in cuts or bruises
CML progresses gradually. It is often slow growing for many years. Over time, it may change into acute myelogenous leukemia (AML). This is a more aggressive type of leukemia. It progresses more rapidly and is more serious.
Cancer occurs when cells in the body become abnormal. They divide without control or order. Leukemia is cancer of the white blood cells and their parent cells. Leukemia cells do not function normally. They cannot do what normal blood cells do. In this case, they can not fight infections. This means that the person is more likely to become infected with viruses or bacteria. The cancerous cells also overgrow the bone marrow. This forces other normal cells, like platelets out. Platelets are needed to help the blood clot. As a result, people with leukemia may bleed more easily.
White Blood Cells
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CML is almost always associated with a gene mutation. The gene is in a chromosome called the
Philadelphia chromosome. This mutation occurs during life. It is not passed from parent to child. In most cases, the cause of the mutation is not known. Studies show that exposure to large doses of radiation is associated with development of CML. It may be found in survivors of nuclear accidents or of atomic bomb blasts. However, most patients with the condition have not been exposed to radiation.
The following factors increase your chance of developing CML:
Sex: maleIncreased ageExposure to atomic bomb radiationExposure to nuclear reactor accidentSmoking is the only lifestyle factor that has been linked to leukemia. Its association with CML is still unclear.
These symptoms may also be caused by other, less serious health conditions. TirednessLack of energyFatigueUnexplained weight lossNight sweatsFeverPain or a feeling of fullness below the ribsBone painJoint painReduced exercise toleranceEnlargement of the liver or spleenUnexplained bleeding or unusual bruising
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your liver and spleen will be examined for swelling. The doctor will also look for swelling in lymph nodes in the armpits, groin, or neck. You will likely be referred to an oncologist. This is a doctor who focuses on treating cancer. Your bodily fluids and tissue may be tested. This can be done with: Blood testsBone marrow aspirationBone marrow biopsyRoutine microscopic examBone, blood marrow, lymph node tissue, or cerebrospinal fluid testsCytogenetic analysisYour doctor may need pictures of your bodily structures. This can be done with: Chest x-rayCT scanMRI scanUltrasound
Talk with your doctor about the best plan for you. Treatment options include:
Targeted drug therapy inhibits the molecule that triggers the development of leukemia and the gene that is associated with it. This medication is often used in early stages of CML.
is the use of drugs to kill cancer cells. It may be given by pill, injection, or via a catheter. The drugs enter the bloodstream and travel through the body. While this will focus on cancer cells, some healthy cells are also killed.
High doses of chemotherapy are followed by a transplant of stem cells (immature blood cells). These will replace blood-forming cells destroyed by cancer treatment. Stem cells are removed from the blood or bone marrow of the patient or donor. They are then infused into the patient.
Lymphocytes are a type of white blood cell. A donor’s cells are infused into the patient. The cancer cells do not recognize these cells. They do not attack them.
is a surgery to remove the spleen. It may be done if the spleen has become enlarged from the leukemia. It may also be done if other complications develop.
There are no guidelines for preventing CML. It is possible that smoking is associated with CML. You may reduce your risk by not smoking.
Last reviewed December 2013 by Mohei Abouzied, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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