Home > Chronic myelogenous leukemia

is a clonal stem cell disorder characterized by excessive proliferation of myeloid cells.

1 Signs and symptoms

The disease is often without specific symptoms. Often it is detected on a routine full blood count.

Symptoms can include: malaise, low grade fever, increased susceptibility to infections, anemia and thrombocytopenia (although an increased platelet count —  thrombocytosis — is often a feature).

2 Diagnosis

CML is often suspected on the basis on the full blood count. When the index of suspicion is high, a bone marrow biopsy is required to distinguish CML from other diseases that feature the same symptoms.

Ultimately, CML is diagnosed by detecting the Philadelphia chromosome (a translocation between the 9th and 22nd chromosome leading to an abberant protein that drives cell division). This translocation leads to bcr-abl fusion and activation of protein tyrosine kinase cascade.

3 Epidemiology

CML occurs in all age groups, but most commonly in the middle-aged and elderly.

4 Treatment

Chronic-phase CML is treated with:

• hydroxyureaHydroxyurea or hydroxycarbamide (brand names include Hydrea®) is an antineoplastic drug used in hematological malignancies. It also acts as an antiretroviral agent by inhibiting ribonucleotide reductase. Uses Polycythemia vera Chronic myelogenous leukemia (hydroxycarbamide)
• alkylating agents
• interferonInterferons (IFNs) are natural proteins produced by the cells of the immune systems of most animals in response to a challenge by a foreign agents such as viruses, bacteria, parasites and tumour cells. Interferons belong to the large class of glycoprotein alpha and steroidIn chemistry and biology, Steroids are a type of lipid, characterized by a carbon skeleton with four fused rings. Hundreds of distinct steroids have been identified in plants and animals. Their most important role in most living systems is as hormones.s
• The new agent ImatinibImatinib is a new drug used to treat certain types of cancer. It is a kind of chemotherapy used in treating chronic myelogenous leukemia (CML), gastrointestinal stromal tumors (GISTs) and a number of other malignancies. It is occasionally referred to as C mesylate (Gleevec®, Glivec®) that specifically targets the abnormality caused by the Philadelphia chromosome.

5 Complications

In a proportion of patients, the disease remains indolent. In a number, however, it proceeds to accelerated phase and eventually blast crisis, which is virtually indistinguishable from acute myelogenous leukemiaAcute myelogenous leukemia AML is also known as Acute Myeloid Leukemia and is specifically a cancer of the myeloid line of white blood cells. It is the most commonly diagnosed type of adult leukemia, and is rare among children. These malignant cells calle and has a very high mortality rate. This stage can most effectively be treated by a bone marrow transplantBone marrow transplantation is a medical procedure that involves stem cell transplantation. The common feature of recipients is a need for blood stem cells. Most recipients are leukemia patients or others who have been exposed to high doses of chemotherap after high-dose chemotherapy.