Chronic Myeloid Leukemia (CML) is a type of blood cancer that originates in the bone marrow and affects the white blood cells. It is a slow-progressing leukemia that primarily affects adults but can occur at any age. CML is characterized by an abnormal chromosome known as the Philadelphia chromosome, which leads to the uncontrolled growth of white blood cells. With advances in treatment, CML is now considered a manageable condition, and many patients live long and healthy lives with proper care.
CML develops due to a genetic mutation in blood-forming stem cells. This mutation creates an abnormal gene called BCR-ABL, which produces an enzyme that signals cells to grow uncontrollably. Over time, the excessive white blood cells accumulate in the bone marrow and bloodstream, impairing normal blood function.
CML is a slow-progressing blood cancer affecting white blood cells.
Caused by a genetic mutation known as the Philadelphia chromosome.
More common in adults but can occur at any age.
Advances in targeted therapy have significantly improved survival rates.
The exact cause of CML is not well understood, but it is primarily linked to a genetic abnormality.
Philadelphia chromosome (BCR-ABL gene mutation) – This abnormal chromosome is present in nearly all CML patients.
Age – CML is more common in older adults, particularly those over 60.
Radiation exposure – High-dose radiation exposure may increase the risk.
Gender – Men are slightly more likely to develop CML than women.
No clear hereditary link – Unlike some cancers, CML is not typically inherited.
CML symptoms may develop gradually, and some individuals may have no symptoms in the early stages.
Fatigue and weakness – Due to anemia caused by excessive white blood cells.
Unexplained weight loss – A result of the body’s energy being consumed by abnormal cell growth.
Fever and night sweats – Symptoms of the body fighting against the cancerous cells.
Frequent infections – Due to compromised immune function.
Easy bruising and bleeding – Caused by a shortage of platelets.
Pain or fullness in the left side of the abdomen – Due to an enlarged spleen.
Bone pain – Due to excessive abnormal cell production in the bone marrow.
CML is classified based on the phase of disease progression rather than traditional stages.
The earliest phase where CML progresses slowly.
Mild or no symptoms.
Easily manageable with targeted therapy.
White blood cell counts increase rapidly.
Symptoms such as fatigue and spleen enlargement worsen.
Treatment becomes more intensive.
The most aggressive phase resembling acute leukemia.
Severe symptoms and increased risk of complications.
Requires intensive treatment like chemotherapy or stem cell transplant.
Early detection of CML significantly improves treatment success. Diagnostic tests help confirm the presence of the Philadelphia chromosome and evaluate the disease progression.
Complete Blood Count (CBC) – Detects abnormal white blood cell levels.
Bone Marrow Biopsy – Examines bone marrow cells for cancerous changes.
Fluorescence in situ hybridization (FISH) – Detects the Philadelphia chromosome.
Polymerase Chain Reaction (PCR) – Confirms the presence of the BCR-ABL gene mutation.
CML treatment focuses on targeting the abnormal BCR-ABL gene, controlling white blood cell production, and preventing progression.
Imatinib (Gleevec), Dasatinib, Nilotinib, Bosutinib, Ponatinib.
These drugs block the BCR-ABL enzyme, stopping cancer cell growth.
Most effective in the chronic phase of CML.
Used in advanced stages or when TKIs fail.
Kills rapidly growing leukemia cells.
The only potential cure for CML, but carries risks.
Used in younger patients or those not responding to other treatments.
Used in cases where TKIs are not effective.
Boosts the immune system to fight leukemia cells.
CML treatment has dramatically improved survival rates, making it a manageable chronic condition for many patients.
5-year survival rate – Over 70-90% with targeted therapy.
Patients responding well to TKIs can live close to a normal lifespan.
Poor prognosis in the blast crisis phase, requiring aggressive treatment.
Early detection and treatment response.
Age and overall health condition.
Phase of CML at diagnosis.
Adherence to treatment – Consistently taking medication is crucial.
There are no definitive ways to prevent CML, but certain measures may reduce risk.
Avoid exposure to high-dose radiation.
Regular medical check-ups to detect early blood abnormalities.
Healthy lifestyle – Balanced diet, exercise, and avoiding smoking may improve overall health and resilience.
CML requires long-term management, but with proper treatment, many individuals live a normal and active life.
Adhering to medication – Taking TKIs as prescribed ensures disease control.
Regular medical follow-ups – Routine blood tests to monitor response.
Healthy lifestyle choices – Nutritious diet, exercise, and stress management.
Emotional and mental well-being – Support groups, therapy, and counseling help in coping with the emotional impact of a chronic illness.