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Chronic myeloid leukemia is a slowly progressing disease in which too many white blood cells (not lymphocytes) are made in the bone marrow. It is also called chronic granulocytic leukemia, chronic myelogenous leukemia, and CML.

CML affects myeloid cells and usually grows slowly at first. It accounts for nearly 5,000 new cases of leukemia each year. It mainly affects adults. The disease affects 1 to 2 people per 100,000 and makes up 7 - 20% cases of leukemia.

Phases of chronic myeloid leukemia

Chronic myelogenous leukemia is grouped into several phases:

  • Chronic: This phase lasts for a few months or years.
  • Accelerated: This is a more dangerous phase during which the leukemia cells grow more quickly.
  • Blast crisis: If untreated, CML progresses to the blast crisis phase. In this phase it is treated similarly to acute myeloid leukemia (AML).

Causes of chronic myeloid leukemia

Chronic myeloid leukemia is usually associated with a chromosome abnormality called the Philadelphia chromosome. Exposure to ionizing radiation is one possible trigger for this chromosome abnormality.

Symptoms of chronic myeloid leukemia

  • Chronic phase
    • Largely asymptomatic or has few symptoms.
  • Accelerated phase
    • Fever (without infection)
    • Bone pain
    • Swollen spleen
  • Blast crisis phase
    • Bleeding and bruising
    • Excessive sweating (night sweats)
    • Fatigue
    • Low-grade fever
    • Pressure under the left ribs from a swollen spleen
    • Sudden appearance of small red marks on the skin (petechiae)
    • Weakness

Diagnostic tests and exams for chronic myeloid leukemia

  • Physical examination to check for swollen spleen
  • Blood test for complete blood count (CBC)
  • Bone marrow aspiration and biopsy
  • CBC with white blood cell differential
  • Testing for the presence of the Philadelphia chromosome

Treatment of chronic myeloid leukemia

  • Imatinib (Gleevec) therapy: Imatinib (Gleevec) is the first therapy for everyone with CML. Gleevec blocks the Philadelphia chromosome and is associated with very high rates of remission.
  • Chemotherapy: Sometimes chemotherapy is used temporarily to control the white blood cell count.
  • Bone marrow transplant or stem cell transplant: This is the only known cure for chronic myeloid leukemia in the blast crisis phase. In a bone marrow transplant or stem cell transplant, the patient receives healthy stem cells through a large vein. New blood cells develop from the transplanted stem cells. The new blood cells replace the ones that were destroyed by treatment.

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