Chronic Myeloid Leukemia: Causes, Symptoms, Diagnosis, Treatment and Prognosis

It is a cancer that affects blood cells, bone marrow, and the soft part within the bones where blood cells are made.

You may also hear your doctor call it chronic myelogenous leukemia. It’s the same disease, just a different name.

With treatment, it can go into what is called “remission.” For most people, that does not mean that the cancer is completely gone, but it is less active than before. You can be in remission for many years.

Chronic myeloid leukemia (CML) usually occurs when you are middle-aged or older. Symptoms tend to appear gradually. Many of them can also be signs of other diseases. For example, you may feel tired, lose weight when you are not trying, or sometimes have a fever.

The disease begins with a problem in the genes in your blood cells . The sections of two different chromosomes change places and create a new abnormal one.

This new chromosome leads your body to make white blood cells that don’t work the way they should. They are called leukemia cells, and when they appear in the bloodstream, there is less room for healthy blood cells.

Causes of chronic myeloid leukemia

Most people will never know what caused them to have chronic myeloid leukemia. It is not usually obtained genetically or from infections. Smoking habits and diet don’t seem to increase your chances of getting it either – the only known risk is if you’ve been in contact with high levels of radiation.

Symptoms

Chronic myeloid leukemia has three phases: chronic, accelerated, and blast. Symptoms depend on which one you are in.

Chronic phase : it is the earliest stage and the easiest to treat. You may not even have symptoms.

Accelerated phase: during this period, the number of blood cells that are not working properly increases. You are more likely to have some of these symptoms:

  1. Feeling very tired
  2. To have a fever.
  3. Get bruises.
  4. Having night sweats
  5. Not having breath.
  6. Lose some weight.
  7. Feeling less hungry.
  8. Swelling or pain on the left side (which could be a sign of an enlarged spleen).
  9. Feel pain in the bones.

Other symptoms may include stroke, vision changes, ringing in the ears, feeling lightheaded, and prolonged erections.

  • Blast phase: Leukemic  cells multiply and crowd out healthy blood cells and platelets.

At this stage, you will have more serious symptoms, including:

  • Infections
  • Bleeding
  • Skin changes including lumps and tumors.
  • Swollen glands
  • Bone-ache.

Get a diagnosis

If you have symptoms, your doctor will want to know:

  • What problems have you noticed?
  • How long have your symptoms been going on?
  • Do your symptoms come and go or are they constant?
  • What makes you feel better or worse?
  • Are you taking any medication?

Your doctor may do more tests to confirm the diagnosis, such as:

  • Complete blood count : This is a blood test that checks how many white blood cells, red blood cells, and platelets there are.
  • Bone marrow test –  Helps find out how advanced your cancer is. Your doctor uses a needle to take a sample, usually from the hip bone.
  • FISH (fluorescent in situ hybridization) test – This is a detailed laboratory test of your genes.
  • Ultrasound or CT scans: They can check the size of your spleen. Ultrasounds use sound waves to make pictures that doctors and other medical professionals can read. A CT scan is an X-ray that takes a series of pictures inside your body.
  • Polymerase chain reaction test : This is a laboratory test that looks for the BCR-ABL gene, which is involved in the process that tells your body to make too many wrong types of white blood cells.

Questions for your doctor

  • Have you already treated someone with chronic myeloid leukemia?
  • What tests should I take to confirm a diagnosis?
  • What phase of chronic myeloid leukemia am I in?
  • What treatment do you recommend?
  • How will therapy make me feel?
  • What if the treatment doesn’t work?
  • How do I find a support group?

Treatment of chronic myeloid leukemia

The goal of your treatment is to destroy the leukemia blood cells in your body and restore healthy ones to a normal level. Usually it is not possible to get rid of all the bad cells.

If you receive treatment during the early chronic phase of chronic myeloid leukemia, you can help prevent the disease from progressing to a more serious level.

Doctors usually first give drugs known as tyrosine kinase inhibitors (TCIs). They slow the rate at which your body makes leukemia cells.

Some commonly used ITCs include:

  • Bosutinib (Bosulif).
  • Dasatinib (Sprycel).
  • Imatinib (Gleevec).
  • Nilotinib (Tasigna).

If your disease continues to get worse after using two or more TBIs, your doctor may suggest a medicine called omacetaxine mepesuccinate (Synribo).

Other chronic myeloid leukemia treatment options include chemotherapy and biologic therapy, which uses a drug called interferon to help stimulate action on your immune system (your body’s defense against germs).

A stem cell transplant could cure some patients. It is a complicated procedure that is usually done only when other treatments do not work.

Stem cells are highly touted in the news, but generally when you hear about them they refer to the “embryonic” stem cells that are used in cloning.

The stem cells in a stem cell transplant are different. These are cells that live in your bone marrow and help make new blood cells.

When you receive a stem cell transplant, a donor will provide you with the new stem cells. You will have to be on a waiting list to find a suitable donor so that your body does not reject them.

Close relatives, such as brothers or sisters, are the best opportunities for a good donor. If that doesn’t work, you should get a list of potential donors from strangers.

Sometimes the most suitable stem cells for you come from someone who is in the same racial or ethnic group.

Self care

Be sure to tell your doctor about any medications you take. Some should not be combined with chronic myeloid leukemia treatments. Follow your doctor’s treatment plan, eat healthy, and exercise when you feel good.

Forecast

Chronic myeloid leukemia is often a slow-growing form of cancer. Although it is difficult to get rid of completely, many people live long lives with chronic myeloid leukemia.

Once you’ve been diagnosed, you should see a hematologist / oncologist, a doctor with special training in diseases of the blood, especially cancer. He will create a treatment plan for you. Always feel free to get a second opinion from another doctor if you wish.

Get help

Be sure to reach out to your family and friends to get the emotional support you need. They can be a great help as you manage your illness.

It also helps to talk with other people who have CML. Ask your doctor about joining a support group, where you can meet people who are going through the same things as you.

The Leukemia and Lymphoma Society can help you find services and support. It has up-to-date information about treating and living with chronic myeloid leukemia, including help for caregivers.