Chronic Myeloid Leukemia (CML)

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What you need to know about Chronic Myeloid Leukemia (CML)

Chronic Myeloid Leukemia (CML) is a type of cancer that affects the blood and bone marrow. It’s characterized by the uncontrolled growth of myeloid cells in the bone marrow, which eventually spills over into the blood.

Types

CML generally has three phases:

Chronic phase: This is the early stage where the disease is often diagnosed. Patients may not have many symptoms.
Accelerated phase: In this phase, the leukemia cells grow more quickly, and symptoms may worsen.
Blast phase (or acute phase): This is the most advanced stage where leukemia cells grow very quickly, resembling acute leukemia.

Causes

Philadelphia Chromosome: The most common cause of CML is a chromosomal abnormality known as the Philadelphia chromosome, resulting from a translocation between chromosomes 9 and 22. This leads to the formation of the BCR-ABL fusion gene, which promotes uncontrolled cell growth.
Other Factors: While the exact cause is unknown, exposure to high doses of radiation and certain chemicals may increase the risk.

Symptoms

Early Symptoms: Often mild or absent, but may include fatigue, weakness, weight loss, abdominal discomfort, and early satiety due to an enlarged spleen.
Advanced Symptoms: Anemia (pallor, weakness), easy bruising or bleeding, fever, night sweats, bone pain, and fullness or discomfort in the abdomen due to an enlarged spleen.

Diagnosis

Blood Tests: Complete blood count (CBC) to check levels of various blood cells.
Bone Marrow Biopsy: To examine the bone marrow for the presence of abnormal cells and chromosomal abnormalities like the Philadelphia chromosome.
PCR Testing: Polymerase chain reaction testing to measure BCR-ABL levels in the blood.

Treatment

Targeted Therapy: Drugs like Imatinib (Gleevec), Dasatinib (Sprycel), Nilotinib (Tasigna), Bosutinib (Bosulif), and Ponatinib (Iclusig) target the BCR-ABL protein.
Chemotherapy: Sometimes used, particularly in advanced stages.
Stem Cell Transplant: Reserved for cases of advanced CML or when other treatments fail.

Prognosis

With Treatment: Many patients with CML have a good prognosis, especially with the advent of targeted therapies. With proper treatment, the majority of patients achieve long-term remission and can live a normal life.
Survival Rates: The survival rates have significantly improved with targeted therapy. The 5-year relative survival rate for CML is high, ranging from 60% to 90%, depending on the stage at diagnosis and the response to treatment.

Prevention

Since Causes Are Unknown: As the exact cause of CML is not fully understood, there are no specific prevention strategies.
Regular Health Check-ups: Early detection through routine check-ups may help in early diagnosis and better outcomes.

Survival rates

Improved Survival: Survival rates have improved significantly with targeted therapy.
Five-Year Survival: The 5-year relative survival rate is generally high, ranging from 60% to 90%, depending on factors such as the stage at diagnosis and response to treatment.

Regular monitoring and adherence to treatment are crucial for better outcomes in CML patients. Early diagnosis and appropriate treatment play a significant role in improving survival rates and quality of life.