(CML)

Also referred to as chronic granulocytic leukemia

Is one of the 4 major 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 uncontained growth of myeloid cells in the bone marrow

Concern occurs becaue 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 brusing
– 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:
– 10-19% myeloblasts are gound in bone marrow or blood
– 20% or more of basophils
– Platelets drop below 100,000 – unrelated to treatment
– Platelets incrase to over 1,000,000 – treatment not helpful
– Change in splen 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

Blood work is often important in diagnosis

Bone marrow biopsy is helpful but additonal 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

. Cytarabine
. Hydroxyurea

Alkylating Agents

Interferon alfa 2b

Steroids