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Chronic Myeloid Leukemia

Chronic Myeloid Leukemia - What it is

​Chronic myeloid leukemia (CML) is a type of blood cancer. In CML, there is increase generation of immature white blood cells as a result of the acquisition of an abnormal chromosome called the Phildelphia chromosome.  This results in the abnormal gene mutation called BCR-ABL. CML is a slow glowing leukaemia and most patients are diagnosed at this chronic phase. Rarely, some patients may have a faster progressive form  and are diagnosed at later stages called accelerated or blast phase where the leukemia transforms into  acute leukemia. 

Chronic Myeloid Leukemia - Symptoms

​Patients with CML may have limited and mild symptoms. It is often that it is detected incidentally on routine blood test. 

Some symptoms that may develop include:
  • Fatigue and tiredness because of anemia
  • Enlarged spleen, leading to symptoms such as abdominal pain and getting full easily after a meal.  
  • Easy bruising or bleeding
  • Loss of appetite and weight
  • Bony pains

Chronic Myeloid Leukemia - How to prevent?

​At present there is no routine screening for CML.

Individuals should seek medical attention if they have any of the above symptoms.

Currently there are also no proven preventive strategies for lymphoma. However, adopting a healthy lifestyle may help to prevent disease. This includes: 
  • Eating a diet rich in fruits and vegetables
  • Quitting or not starting smoking
  • Limiting alcohol consumption
  • Regular exercise

Chronic Myeloid Leukemia - Causes and Risk Factors

​CML occurs in the presence of Philadelphia chromosomes resulting in a BCR-ABL gene mutation in genes which is involved in the regulation of blood cell production. The cause of the gene mutation is unknown and is usually not an inheritable mutation. 

Chronic Myeloid Leukemia - Diagnosis

The confirmation of CML requires the demonstration of the Philadelphia chromosome or BCR-ABL mutation which can be done via a blood test or a bone marrow test. 

A bone marrow aspirate and trephine biopsy is usually required not only to aid in diagnosis but also to help stage the disease into either the chronic, accelerated or blast phase based on the percentage of very immature blood cells called blast.

Chronic Myeloid Leukemia - Treatments

​With targeted therapy, CML has become a very treatable condition for many patients with the disease. 

In CML the target is tyrosine kinase which is the protein produced by the BCR-ABL mutated gene. 
Target therapy drugs called tyrosine kinase inhibitors include: 
  • Imatinib
  • Dasatinib
  • Nilotinib
  • Ponatinib
The choice between these agents is dependent on patient and disease characteristics. These drugs are extremely effective in treating CML and patients are monitored regularly for the presence of the BCR-ABL gene to monitor response to therapy. 

In certain patients, this therapy may be stopped after achieving a deep response for a period of time. This is called treatment free remission. 

While most patients respond very well to tyrosine kinase inhibitors, some patients may have more aggressive disease or have developed resistance to the therapy. In such cases conventional chemotherapy may be required and those in this situation may require a haematopoietic stem cell transplant. 

Chronic Myeloid Leukemia - Preparing for surgery

Chronic Myeloid Leukemia - Post-surgery care

Chronic Myeloid Leukemia - Other Information

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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