The Basics
Written by the doctors and editors at UpToDate � �
What is chronic myeloid leukemia? " � Chronic myeloid leukemia, called "CML, " � is a type of blood cancer. Blood is made up of different types of cells. These cells are made in the middle of your bones, in a part called the bone marrow. � �
People with CML have an abnormal gene in some of their blood cells. This gene causes the bone marrow to make abnormal blood cells. These abnormal blood cells can grow out of control, get into the blood, and travel around the body. Sometimes, these cells collect in certain parts of the body. � �
When the bone marrow makes abnormal blood cells, it does not make enough of the normal blood cells a persons body needs. This can cause symptoms. � �
There are 3 stages, or "phases, " � of CML: � �
- During the chronic phase, the cancer grows very slowly. Most people are in this phase when their CML is diagnosed. This phase can last for years.
- During the accelerated phase, the cancer begins to grow faster.
- During the blast phase, the cancer is fast-growing and can be fatal.
Treatment depends, in part, on the phase of your CML. � �
What are the symptoms of CML? " � CML does not always cause symptoms, especially at first. When it does cause symptoms, the most common ones are: � �
- Feeling very tired and weak
- Sweating much more than usual, or losing weight without trying to
- Feeling full after eating a small amount of food
- Bleeding more easily than normal
Is there a test for CML? " � Yes. Your doctor or nurse will talk with you, do an exam, and do blood tests. He or she might also do a bone marrow biopsy. For this test, a doctor takes a very small sample of the bone marrow. Then another doctor will look at the cells under a microscope to see if abnormal (cancer) cells are present. � �
How is CML treated? " � Doctors can treat CML in different ways. When CML is first diagnosed and in the chronic phase, it is treated with medicines that come in pills called "tyrosine kinase inhibitors " � or "TKIs. " � TKIs kill the blood cells that have the CML abnormal gene. When these blood cells are gone, the bone marrow can work normally again. TKIs do not cure CML, but they can control it for many years. If you take a TKI, it is very important to take every single dose. Skipping pills can allow the CML to grow out of control. Most people with CML must take a TKI for the rest of their life. � �
People who have too many side effects from their TKI, or whose CML starts to grow faster, can have other treatments. These can include: � �
- Another TKI " � Different TKIs have different side effects. Also, 1 TKI might work better to control your CML than another. If 1 TKI doesn't work for you, another might.
- Chemotherapy " � Chemotherapy is the term doctors use to describe a group of medicines that kill cancer cells.
- Bone marrow transplant " � This treatment replaces cells in the bone marrow that are killed by chemotherapy or radiation. (Radiation kills cancer cells.) These "donor " � cells can come from another person whose blood matches yours.
- A type of medicine called "interferon alpha " �
Treatment also involves regular follow-up visits, exams, and blood tests. As part of follow up, some people also need bone marrow biopsies. � �
What else should I do? " � It's important to follow all your doctor's instructions about visits, tests, and treatment. It's also important to talk to your doctor about any side effects or problems you have during treatment. � �
Getting treated for CML involves making many choices, such as what treatment to have and when. � �
Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask: � �
- What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
- What are the downsides to this treatment?
- Are there other options besides this treatment?
- What happens if I do not have this treatment?
All topics are updated as new evidence becomes available and our peer review process is complete. � �
This topic retrieved from UpToDate on: Nov 04, 2014. � �
Topic 15792 Version 4.0 � �
Release: 22.8 - C22.208 � �
� � 2014 UpToDate, Inc. All rights reserved. � �
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.The use of UpToDate content is governed by the UpToDate Terms of Use. � �2014 UpToDate, Inc. All rights reserved. � �
Copyright
� � 2014 UpToDate, Inc. All rights reserved. � �