Chronic Myelogenous Leukemia (CML) is also referred to as Chronic Granulocytic Leukemia

It is one of the 4 main types of Leukemia

The other major types of Leukemia are:

1.) Acute Lymphoblastic Leukemia (ALL)

2.) Acute Myelogenous Leukemia (AML)

3.) Chronic Lymphocytic Leukemia (CLL)

 

CML is when there is a large and often uncontainable growth of myeloid cells in the bone marrow.

Concern occurs because these cells can over-grow the normal blood cells.

This disease starts with the stem cells that produce a group of cells such as basophils, eosinophils, and neutrophils.

Therefore classified as a “myeloproliferative disease“.

Symptoms

  • Typically no symptoms are found until later in staging
  • Fatigue
  • Fever
  • Increased infections
  • Increased bruising
  • Enlargement of spleen

Cause:

  • Genetic

Classifications

1.)  Chronic phase

  • Most patients are in this phase at the time of diagnosis
  • Usually no symptoms
  • This stage lasts for an unknown amount of time and is different for each individual
  • The progression of this stage to another stage will occur without treatment

2.)  Accelerated phase

  • When any of the below are found:
  • Myeloblasts are found in bone marrow or blood
  • 20% or more of basophils
  • Platelets drop below 100,000 – unrelated to treatment
  • Platelets increase to over 1,000,000 – treatment not helpful
  • Change in spleen size
  • Large change in white blood count

3.)  Blast crisis

  • This is the final stages
  • This transition changes from a chronic progression to an acute leukemia
  • Blasts [large amount] are found in the bone marrow
  • Chloroma formation – Leukemia mass or area is found outside bone marrow
  • 20% plus myeloblasts or lymphoblasts

 

Diagnosis

  • Blood work is often important in diagnosis
  • Bone marrow biopsy is helpful but additional tests are required for a specific diagnosis

 

Treatment

Chronic Phase:

  • Main form of treatment

Tyrosine Kinase –

Imatinib mesylate (STI-571, Gleevec, Glivec)

  • Other newer options

.  Dasatinib
.  Nilotinib

  • Bone marrow transplants
  • Other possible but older treatment options
  • Antimetabolites

.  Hydroxyurea

  • Alkylating Agents
  • Interferon alfa 2b
  • Steroids
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