Summary about Disease
Chronic myelogenous leukemia (CML) is a type of cancer that starts in the bone marrow. It is characterized by the overproduction of abnormal white blood cells (myeloid cells). It's a slowly progressing blood and bone marrow disease that mainly affects adults. The abnormal cells crowd out the healthy blood cells, leading to various complications.
Symptoms
Many people with CML don't have symptoms initially. When symptoms do appear, they can be vague and may include:
Fatigue
Weakness
Weight loss
Fever
Night sweats
Bone pain
Enlarged spleen (feeling of fullness in the upper left abdomen)
Easy bleeding or bruising
Frequent infections
Causes
CML is caused by a specific genetic mutation called the Philadelphia chromosome. This chromosome is formed when parts of chromosomes 9 and 22 break off and switch places. This creates a new gene called BCR-ABL1, which directs the bone marrow to produce too many abnormal white blood cells. The exact reason why this chromosomal translocation occurs is unknown in most cases.
Medicine Used
The primary treatment for CML is targeted therapy with tyrosine kinase inhibitors (TKIs). Common TKIs include:
Imatinib (Gleevec)
Dasatinib (Sprycel)
Nilotinib (Tasigna)
Bosutinib (Bosulif)
Ponatinib (Iclusig) Other treatments, though less common due to TKI effectiveness, include:
Chemotherapy
Stem cell transplant (bone marrow transplant)
Interferon
Is Communicable
No, CML is not communicable. It is a genetic disease and cannot be spread from person to person.
Precautions
There are no specific precautions to prevent CML since the cause is usually unknown. However, people with CML should take precautions to:
Avoid infections (frequent handwashing, avoid crowds during flu season).
Manage side effects of treatment with the guidance of their doctor.
Maintain a healthy lifestyle to support their immune system.
How long does an outbreak last?
CML is not an "outbreak" disease. It's a chronic condition, meaning it can last for many years, even a lifetime. Treatment aims to control the disease and prevent it from progressing. Without treatment, CML progresses through phases: chronic, accelerated, and blast crisis (acute leukemia).
How is it diagnosed?
CML is typically diagnosed through:
Blood tests: Complete blood count (CBC) to identify abnormal white blood cell levels.
Bone marrow aspiration and biopsy: Samples of bone marrow are taken to examine the cells and confirm the presence of the Philadelphia chromosome or BCR-ABL1 gene.
Cytogenetic testing: Analysis of chromosomes in blood or bone marrow cells.
FISH (fluorescence in situ hybridization): A lab test that detects specific DNA sequences in cells.
PCR (polymerase chain reaction): A lab test that detects the BCR-ABL1 gene.
Timeline of Symptoms
CML often progresses slowly, and early symptoms can be mild or absent.
Early (Chronic Phase): May have no symptoms or mild symptoms like fatigue, weakness, or weight loss.
Accelerated Phase: Symptoms become more pronounced and may include fever, night sweats, bone pain, and enlarged spleen. Blood counts worsen.
Blast Crisis Phase: CML transforms into acute leukemia. Symptoms are severe and can include frequent infections, bleeding, and severe fatigue. This phase is life-threatening. The timeline for progression varies significantly among individuals.
Important Considerations
Adherence to Treatment: TKIs are highly effective but must be taken regularly as prescribed by a physician. Non-adherence can lead to disease progression.
Monitoring: Regular blood tests and bone marrow exams are necessary to monitor the disease and adjust treatment as needed.
Side Effects: TKIs can cause side effects, which should be discussed with the doctor for management.
Fertility: CML and its treatment can affect fertility. It's important to discuss fertility options with a doctor before starting treatment.
Clinical Trials: Participation in clinical trials may be an option.