Chronic Myeloid Leukemia (CML)

The Basics

Written by the doctors and editors at UpToDate пїЅ пїЅ

What is chronic myeloid leukemia? " пїЅ Chronic myeloid leukemia, called "CML, " пїЅ 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. пїЅ пїЅ

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. пїЅ пїЅ

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. пїЅ пїЅ

There are 3 stages, or "phases, " пїЅ of CML: пїЅ пїЅ

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. пїЅ пїЅ

What are the symptoms of CML? " пїЅ CML does not always cause symptoms, especially at first. When it does cause symptoms, the most common ones are: пїЅ пїЅ

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? " пїЅ 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. пїЅ пїЅ

How is CML treated? " пїЅ 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 " пїЅ or "TKIs. " пїЅ 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. пїЅ пїЅ

People who have too many side effects from their TKI, or whose CML starts to grow faster, can have other treatments. These can include: пїЅ пїЅ

Another TKI " пїЅ 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 " пїЅ Chemotherapy is the term doctors use to describe a group of medicines that kill cancer cells.
Bone marrow transplant " пїЅ This treatment replaces cells in the bone marrow that are killed by chemotherapy or radiation. (Radiation kills cancer cells.) These "donor " пїЅ cells can come from another person whose blood matches yours.
A type of medicine called "interferon alpha " пїЅ

Treatment also involves regular follow-up visits, exams, and blood tests. As part of follow up, some people also need bone marrow biopsies. пїЅ пїЅ

What else should I do? " пїЅ 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. пїЅ пїЅ

Getting treated for CML involves making many choices, such as what treatment to have and when. пїЅ пїЅ

Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask: пїЅ пїЅ

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. пїЅ пїЅ

This topic retrieved from UpToDate on: Nov 04, 2014. пїЅ пїЅ

Topic 15792 Version 4.0 пїЅ пїЅ

Release: 22.8 - C22.208 пїЅ пїЅ

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Chronic Myeloid Leukemia (CML)

The Basics

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