Patient's Complete Guide to CML- Chronic Myeloid Leukemia

Overview of CML- Chronic Myeloid Leukemia

Chronic myeloid leukaemia is a type of cancer in which there is excessive growth of white blood cells without any differentiation. Consequently, there is overproduction of immature blast cells.

Signs and Symptoms of CML- Chronic Myeloid Leukemia

Chronic myeloid leukaemia (Daimi sartaan khoon/دائمی سرطان  خون ) is a myeloproliferative disorder. It is white blood cells cancer in which increased proliferation of the granulocytic cell line. So, there is an increased number of granulocytes, blast cells and immature precursors on the peripheral blood cell profile. It accounts for 20% of all leukaemia affecting adults. It's a type of cancer that starts in certain blood-forming cells of the bone marrow.

CML Stages

The growth or spread of CML is called the phase or stages. There are the following stages of CML to estimate its growth.

  • Chronic Stage

The blood and bone marrow contain >10% immature white blood cells (blast cells). This phase can last for several years. However, without effective treatment, the disease can progress to the accelerated or blast phases. About 90% of people have chronic phase CML when they are diagnosed. Abdomen might be swollen due to an enlarged spleen. Some people with chronic phase CML have symptoms when they are diagnosed and some do not. Most symptoms are treatable.

  • Accelerated Stage

In this phase of CML patients have 10% - 19% blasts in both the blood and bone marrow or > 20% basophils in the peripheral blood.  These cells sometimes have new cytogenetic changes in addition to the Philadelphia chromosome, because of additional DNA damage and mutations in the CML cells.

  • Blast Stage

In the blast phase, there are 20% or more blasts in the blood or bone marrow, and it is difficult to control the number of white blood cells. The CML cells often have additional genetic changes as well. The blast cells can look like the immature cells seen in patients with other types of leukaemia, specifically acute lymphoblastic leukaemia.  . Patients in the blast phase have a fever, an enlarged spleen and weight loss.

  • Resistant CML

Resistant CML is CML that occurs when it does not respond to treatment. If the CML does recur, there will be another round of tests to learn about the extent of the disease.

  • CML Prevalence

Globally, about 15% of all new cases of leukaemia are chronic myeloid leukaemia. About 1 person in 526 will get CML in their lifetime. The average age at diagnosis of CML is around 64 years. Almost half of the cases are diagnosed in people 65 and older.

Types of CML- Chronic Myeloid Leukemia

Some common signs and symptoms of CML are as follows:

  • Low level of RBCs( Anemia) leads to shortness of breath, fatigue and weakness
  • Leukopenia is a shortage of normal white blood cells leads to a high risk of infections
  • Neutropenia means that the level of normal neutrophils is low leads to bacterial infections
  • Thrombocytopenia is a shortage of blood platelets which causes frequent bleeding and bruises

Other signs and symptoms may include:

  • Bone Pain
  • Enlarged spleen
  • Feeling to be filled after eating small
  • Fever
  • Weight loss
  • Lack of appetite
  • High level of sweating at night
  • Pain under ribs

Prevention

Factors that increase the risk of chronic myelogenous leukaemia:

  • Radiation exposure:  Mostly in those who are being exposed to high-dose radiation may be at the risk of getting CML.
  • Age:  It is higher in older patients.
  • Gender: It mostly occurs in males rather than in females.

Diagnosis

The only potentially avoidable risk factor for CML is exposure to high doses of radiation and there is no other prevention which can prevent CML.

Treatment of CML- Chronic Myeloid Leukemia | When to Consult a Doctor

  • Bone marrow Biopsy

  • Complete blood count tests reveal the blood cells with a lot of early (immature) cells called myeloblasts or blasts

  • Bone marrow test in which the bone marrow is often hypercellular because it's full of leukaemia cells
  • Blood chemistry tests show high and low levels of mineral
  • Genetic tests are used to look for BCR-ABL gene
  • Conventional cytogenetic
  • Fluorescent in situ hybridization (FISH) is also used to check the presence of pieces of BCR-ABL gene on chromosome
  • Polymerase chain reaction (PCR) is used to check the quantity of genes. It can detect even a minute amount of BCR-BCL in leukaemia cells.  During treatment, it is used to detect copies of BCR-ABL even when cells are not seen under a microscope
  • Computed tomography (CT) scan used to check the growth of leukaemia in an organ
  • Magnetic resonance imaging (MRI) is helpful to check growing of leukaemia in the brain and spinal cord
  • Ultrasound is used to check lymph nodes near Kidney spleen and liver

Healthcare Providers

Consult with Best Doctors for CML- Chronic Myeloid Leukemia

Dr. Amjad S.k Durrani, Oncologist
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Dr. Rab Nawaz Maken

Speciality for CML- Chronic Myeloid Leukemia

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