Chronic Myeloid Leukemia (CML)

Leukemia is a cancer of white blood cells. White blood cells have many jobs, including helping your body's immune system fight off infection. White blood cells form in your bone marrow, the spongy tissue inside your bones.

With leukemia, you have a very high white blood cell count. However, the cancerous white blood cells don't work properly, so you're likely to get infections. Those infections may be life-threatening.

Also, the cancerous white blood cells fill up your bone marrow so it can't make normal blood cells such as:

• Red blood cells (causing anemia)

• Normal white blood cells (increasing the risk of infection)

• Platelets (increasing the risk of bleeding)

There are many different types of white blood cells but only 2 main types of leukemia:

• Lymphocytic leukemia: cancer of lymphocytes, which are one type of white blood cell

• Myelogenous leukemia: cancer of all the other types of white blood cells

Lymphocytic and myelogenous leukemia can be acute or chronic:

• Acute: cancer of young cells that spreads quickly and can cause death in 3 to 6 months if untreated

• Chronic: cancer of mature cells that spreads more slowly

Chronic myeloid leukemia (CML) is a type of slow-growing cancer of one of several different types of white blood cells. The cancer cells grow and spread into your blood and to other parts of your body.

• CML happens most often in adults between ages 40 and 60

• You may feel tired and have no appetite and lose weight

• As the cancer grows, you may also be pale and bruise or bleed easily

• Doctors find CML with blood tests and bone marrow exams

• CML is treated with medicines called TKIs (tyrosine kinase inhibitors)

• More than 90% of people treated early survive at least 5 years

CML has 3 stages:

• Chronic phase: the first months or years when the cancer grows very slowly

• Accelerated phase: the cancer begins to grow more quickly, treatments don’t work as well, and symptoms get worse

• Blast phase: very young cancer cells called blasts show up and the cancer becomes much worse, with problems such as serious infections and bleeding

CML is caused by a problem with one of your chromosomes. Each of your body's cells has 46 chromosomes. The chromosomes contain DNA, which determines how your cells work.

In CML, one of your chromosomes develops an abnormality. The abnormal chromosome is called the Philadelphia chromosome. It produces a substance that makes one type of white blood cell grow abnormally and out of control.

Early on, CML may cause no symptoms. When symptoms first appear, they may include:

• Feeling weak and tired

• Not feeling hungry

• Weight loss

• Fever

• Sweating at night

• Feeling a fullness in the upper belly (due to a large liver and spleen)

Later, you may become sicker and have symptoms such as:

• Fever (from infections or the leukemia)

• Bruising

• Bleeding

To tell if you have CML, doctors will:

• Do blood tests

• Take a sample of your bone marrow to test (bone marrow exam)

• Do molecular testing to look for the Philadelphia chromosome

Doctors treat CML with:

• Medicines called TKIs (tyrosine kinase inhibitors)

• Chemotherapy

• Stem cell treatment, if needed