Chronic Myelogenous Leukemia

Chronic myelogenous leukemia (CML) is a rare form of cancer of the blood cells. It is called chronic because it develops more slowly than other forms of leukemia, which are considered acute. No one knows the exact cause of CML.

RISK FACTORS

  • Having a chromosome abnormality called Philadelphia chromosome. Chromosomes contain your genes, which determine your physical traits, such as eye color or hair color.  

  • Having had radiation treatment for some other condition or form of cancer.  

  • Being an adult. CML usually occurs later in life and is rare in children.

SYMPTOMS

At first, there may be no symptoms. After a while, some symptoms may occur, such as:

  • Feeling more tired than usual.

  • Feeling tired after rest.  

  • Unplanned weight loss.  

  • Heavy sweating at night.  

  • Fever.  

  • Paleness.  

  • A feeling of fullness in the upper left part of the abdomen.  

  • Easy bruising or bleeding.  

  • More frequent infections.  

DIAGNOSIS

Your health care provider may perform the following exams or tests to help diagnose CML:

  • A physical exam to check for an enlarged spleen, liver, or lymph nodes.  

  • Blood (CBC with differential) tests.

  • Bone marrow tests.

  • Tests to check for the presence of Philadelphia chromosome as well as other abnormalities. These may include cytogenetic analysis, fluorescence in situ hybridization (FISH), and a reverse transcription polymerase chain reaction (RT–PCR) test.

TREATMENT

There are different types of treatment used for this condition, including:

  • Targeted drugs—These medicines interfere with chemicals the leukemia cells need in order to grow and multiply.  

  • Chemotherapy drugs—These medicines kill cells that are multiplying quickly, such as leukemia cells.  

  • Biological therapy—This treatment boosts the ability of your immune system to fight the leukemia cells.  

  • Bone marrow or peripheral blood stem cell transplant—This treatment allows you to receive very high doses of chemotherapy or radiation, or both. These high doses kill the cancer cells, but they also destroy the bone marrow. After treatment is complete, you are given donor bone marrow or stem cells, which will replace the bone marrow.  

  • Surgery to remove the spleen.

HOME CARE INSTRUCTIONS

  • Take all medicines exactly as directed by your health care provider.

  • Although some of your treatments might affect your appetite, try to eat regular, healthy meals.  

  • If you develop any side effects, tell your health care provider. He or she may have recommendations of things you can do to improve symptoms.  

  • Consider learning some ways to cope with the stress of having a chronic illness, such as by doing yoga or meditation or by participating in a support group.  

SEEK MEDICAL CARE IF:

  • You feel lightheaded.  

  • You notice pain, swelling, or redness anywhere in your legs.  

  • You have a fever or persistent symptoms for more than 2–3 days.

  • You have a fever and your symptoms suddenly get worse.

  • You have uncontrollable bleeding, such as a nosebleed that will not stop.  

  • You are unable to stop vomiting.  

  • You cannot keep liquids down.  

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop chest pains.  

  • You have trouble breathing or feel short of breath.  

  • You faint.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.