Cancer, Chronic Myelogenous Leukemia

Chronic myelogenous leukemia (CML) is a rare type of cancer that starts in the bone marrow. Bone marrow is the soft, inner part of your bones, where blood cells are created. CML causes the body to make too many white blood cells.

The word "chronic" means CML usually develops slowly, unlike some other, faster-growing types of leukemia. "Myelogenous" describes the specific type of blood cell affected by the cancer. This type of cancer is sometimes also called chronic myeloid leukemia or chronic granulocytic leukemia.

CML most often affects older adults, but can occur at any age, though it's less common in children.

Medical treatments for CML have greatly improved. Many people with CML can go into remission, meaning the cancer is under control, and live long, healthy lives after diagnosis.

Looking for treatment?

We are accepting new patients for CML treatment. Our team of experts is ready to schedule your appointment now.

Locations:

• Arizona: 520-667-2117
• Florida: 904-895-7709
• Minnesota: 507-792-8724

Chronic myelogenous leukemia (CML) is a type of cancer that often doesn't show any noticeable symptoms at first. Sometimes, it's only discovered when a routine blood test is done.

If symptoms do appear, they might include:

• Bone pain: This can range from a mild ache to a more severe, persistent pain in the bones.
• Easy bleeding: Bruising easily, or bleeding from cuts that take longer to stop than usual, are signs of this.
• Feeling full quickly: Even after eating a small amount of food, you might feel overly full.
• Fatigue: This means feeling unusually tired and lacking energy.
• Fever: A persistent fever, often accompanied by chills, could be a symptom.
• Unexplained weight loss: Losing weight without trying to diet or exercise can be a sign of an underlying health problem.
• Loss of appetite: A reduced desire to eat, even if you're not trying to lose weight, might be a symptom.
• Pain or fullness in the left side of the abdomen: This discomfort might be felt below the ribs and can be due to swelling in the spleen.
• Night sweats: Sweating excessively during sleep is another potential symptom.
• Blurred vision: If bleeding occurs in the back of the eye, it can cause blurry or double vision.

It's important to note that these symptoms can be caused by other health issues. If you experience any of these, it's crucial to see a doctor for a proper diagnosis.

If you're experiencing any ongoing health problems that are causing you concern, it's important to schedule a visit with your doctor or other healthcare professional. Don't ignore symptoms that bother you. Talking to your doctor can help determine the cause and get you the right treatment.

Chronic myelogenous leukemia (CML) is a type of blood cancer. In most people with CML, their blood cells have an unusual chromosome called the Philadelphia chromosome.

Normally, our bodies have 23 pairs of chromosomes. These chromosomes are made of DNA, which carries the instructions for all our cells' functions. Think of it like a detailed instruction manual for each cell.

In CML, something goes wrong in the bone marrow, the part of your body that makes blood cells. Scientists aren't entirely sure what triggers this, but they know how it progresses.

Specifically, parts of chromosome 9 and chromosome 22 swap places. This creates a shortened chromosome 22 (the Philadelphia chromosome) and a slightly longer chromosome 9. This rearranged chromosome combination is the key to CML development.

This rearranged structure leads to a new gene called BCR-ABL. This new gene tells the blood cells to produce too much of a protein called tyrosine kinase. Normally, tyrosine kinase helps control cell growth, but in CML, it's overactive. This overactive tyrosine kinase encourages uncontrolled growth of certain white blood cells.

Healthy bone marrow produces blood stem cells, which mature into red blood cells, white blood cells, and platelets. In CML, this process breaks down. The overactive tyrosine kinase causes an excessive number of white blood cells to multiply. These abnormal white blood cells, which almost always carry the Philadelphia chromosome, don't die off like normal cells. Instead, they keep dividing, crowding out healthy blood cells and damaging the bone marrow. This excess of abnormal cells is what causes the symptoms of CML. About 90% of people with CML have the Philadelphia chromosome.

Chronic myelogenous leukemia (CML) is a type of blood cancer. Several factors can increase the chances of getting it, but there's no way to prevent it.

One risk factor is age. CML is more often diagnosed in older adults compared to younger people, like children and teenagers.

Another factor is sex. Men are slightly more likely to develop CML than women.

Also, exposure to radiation may play a role. Radiation treatments for some cancers have been associated with a higher risk of CML later in life.

Importantly, there's no way to avoid getting CML. If someone develops the disease, it wasn't something they could have prevented.

The genetic change that causes CML isn't inherited from parents. Instead, it's thought to happen after a person is born. This means that the genetic change that leads to CML is not something a person is born with. It occurs later in life.

Diagnosing Chronic Myelogenous Leukemia (CML) involves several tests and procedures to understand the disease's severity and best treatment approach.

Getting a Sample of Bone Marrow:

A healthcare professional uses a thin needle to collect a small amount of liquid bone marrow. This is usually done in the hip bone area. Often, a bone marrow biopsy is done at the same time. A biopsy involves taking a small piece of bone tissue along with the marrow inside. This allows doctors to examine both the solid and liquid components of the bone marrow.

Tests Used to Diagnose CML:

Several tests help diagnose CML:

• Blood Tests: A blood sample is drawn using a needle and sent to a lab. A complete blood count (CBC) is performed to check the number of different types of blood cells. In CML, there's often a high number of white blood cells. Blood tests also check the function of different organs to see if anything is not working correctly.

• Bone Marrow Tests: As mentioned, bone marrow biopsies and aspirations are used to analyze bone marrow samples. Bone marrow is made up of solid and liquid parts. The biopsy collects a bit of the solid bone tissue, and the aspiration collects the liquid marrow. These samples are sent to a lab for further testing.

• Philadelphia Chromosome and BCR-ABL Gene Tests: Special tests analyze the blood or bone marrow samples to look for the Philadelphia chromosome or the BCR-ABL gene. These genes are often changed in CML. Two common tests used are fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR).

Understanding the Stages of CML:

The stage of CML describes how aggressive the disease is. Doctors determine the stage by comparing the number of abnormal cells to the number of healthy cells in the blood or bone marrow. A higher ratio of abnormal cells suggests a more advanced stage of the disease.

CML Stages:

• Chronic Phase: This is the earliest stage, and it generally responds best to treatment. The number of abnormal cells is lower compared to other stages.

• Accelerated Phase: This is an intermediate stage where the disease becomes more aggressive. The abnormal cells are increasing in number.

• Blast Phase: This is the most severe and aggressive stage. The abnormal cells rapidly multiply, making it a life-threatening situation. The number of abnormal cells is significantly high.

Chronic Myelogenous Leukemia (CML) Treatment Explained

Chronic myelogenous leukemia (CML) is a blood cancer. The goal of treatment is to get rid of the abnormal blood cells that have the BCR-ABL gene. This gene creates a faulty protein that causes the cancer to grow.

Targeted Therapy: The First Line of Defense

Most people with CML start with targeted therapy. This type of treatment uses special medicines that precisely target and attack specific parts of the cancer cells. In CML, these medicines, called tyrosine kinase inhibitors (TKIs), are aimed at the faulty tyrosine kinase protein produced by the BCR-ABL gene. This helps stop the cancer cells from growing and multiplying.

How TKIs Work and Potential Side Effects

TKIs are often the first treatment for CML. They work well for many people, often putting the disease into remission. However, like any medicine, TKIs can cause side effects. These can include skin swelling, nausea, muscle aches, tiredness, diarrhea, and skin rashes.

Monitoring Treatment Effectiveness

Doctors use blood tests to see if the BCR-ABL gene is still present. This helps them understand how well the targeted therapy is working. If the treatment isn't effective, or if the cancer becomes resistant, the doctor might try a different TKI or another type of treatment.

Long-Term Treatment

Doctors haven't figured out a safe time to stop TKI treatment. Most people keep taking these medicines even when tests show the cancer is in remission, because the cancer can come back. However, you and your doctor can discuss the pros and cons of stopping treatment in certain situations.

Bone Marrow Transplant: A Potential Cure

A bone marrow transplant (or stem cell transplant) is the only treatment that can sometimes cure CML. It's usually reserved for people whose CML hasn't responded to other treatments, because it's a major procedure with risks and potential complications.

How a Bone Marrow Transplant Works

In a bone marrow transplant, high doses of chemotherapy drugs are used to kill the patient's own blood-forming cells in the bone marrow. Then, healthy stem cells from a donor are given to the patient. These new cells create healthy blood cells, replacing the diseased ones.

Chemotherapy: Another Treatment Option

Chemotherapy uses powerful drugs to kill cancer cells. Sometimes, chemotherapy is combined with targeted therapy, especially if the CML is more aggressive. The side effects of chemotherapy depend on the specific drugs used.

Clinical Trials: Accessing New Treatments

Clinical trials test new treatments. They can be a way to try the latest approaches, but the side effects might not be fully understood. Talk to your doctor about whether a clinical trial might be an option.

Alternative Medicine for CML

There aren't any alternative medicines proven to cure CML. However, alternative therapies can help manage common side effects like fatigue.

Understanding and Managing Fatigue

Fatigue is a common symptom of CML, often a side effect of treatment, or stress of living with a chronic condition. Doctors can treat the underlying causes of fatigue, but sometimes medication alone isn't enough.

Alternative Therapies for Fatigue

Alternative therapies that may help with fatigue include:

• Exercise: Regular physical activity can improve energy levels.
• Journaling: Writing down thoughts and feelings can help manage stress.
• Massage: Relaxation techniques can reduce physical and mental tension.
• Relaxation techniques: Deep breathing and meditation can help reduce stress.
• Yoga: Yoga combines physical postures, breathing exercises, and meditation.

It's essential to discuss these options with your doctor to create a personalized plan to manage fatigue effectively.

Living with Chronic Myelogenous Leukemia (CML)

Chronic myelogenous leukemia (CML) is a long-term condition for many people. Treatment often involves taking targeted therapy medications indefinitely. Sometimes, even though you might not look sick, you might feel unwell. Other days, you might just be tired of dealing with cancer. Here's how to take care of yourself:

Managing Side Effects:

• Talk to your doctor about side effects: Powerful cancer medications can cause various side effects. These side effects can often be managed with other medications or treatments. Don't try to handle them alone. Let your doctor know what you're experiencing.
• Don't stop treatment without your doctor's permission: If you develop side effects like a rash or fatigue, don't stop your medications without talking to your doctor. Similarly, don't stop taking your medicine even if you feel better and think your cancer is gone. Stopping treatment could cause your cancer to return quickly, even if you're in remission.

Seeking Support:

• Ask for help when you need it: Dealing with a chronic illness can be emotionally challenging. Tell your doctor how you're feeling. They can refer you to a therapist or counselor to talk through your emotions.

Taking Control of Your Care:

• Learn about your specific cancer: The word "leukemia" is a broad term, covering several types of cancers affecting the bone marrow and blood. Focusing on information specific to your type of CML is crucial.

  Ask your medical team to explain your specific diagnosis clearly. Then, limit your research to reliable sources, such as the Leukemia & Lymphoma Society.

• Keep connections with loved ones: A CML diagnosis can be stressful for your friends and family too. Maintain your relationships.

  Let your loved ones know how they can support you. Perhaps you need help with household chores while hospitalized, or simply someone to listen.

  The support of friends and family can be invaluable.

• Find support groups: Connect with others facing similar challenges. Ask your doctor for recommendations for counselors or medical social workers. Look for support groups through the American Cancer Society or other local groups offered by your hospital or community.

By actively managing side effects, seeking support, and educating yourself about your specific condition, you can better navigate the challenges of living with chronic myelogenous leukemia. Remember, you're not alone, and there are resources available to help you every step of the way.