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Chronic Myelogenous Leukemia

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. The primary concerns often arise  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:

–  Largely believed to be 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