Chronic myelogenous leukemia (CML)
Key points
- Chronic myelogenous leukemia is a malignant cancer of the bone marrow.
- The disease can occur in adults (usually middle-aged) and children.
- Chronic myelogenous leukemia is characterized by a chronic phase that can last for months or years.
- Treatment is aimed at reducing the growth of the leukemic cells in the bone marrow and may bring about a remission (when no leukemia can be found) with good control of the symptoms of the disease.
Alternative names
Chronic granulocytic leukemia
Definition
Chronic myelogenous leukemia is a malignant cancer of the bone marrow. It causes rapid growth of the blood-forming cells (known as myeloid precursors) in the bone marrow, peripheral blood, and body tissues.
Causes, incidence, and risk factors
The disease can occur in adults (usually middle-aged) and children. CML affects 1 to 2 people per 100,000 and accounts for 7-20% cases of leukemia. It is usually associated with a chromosome abnormality called the Philadelphia chromosome.
Exposure to ionizing radiation is one possible trigger for this chromosome abnormality. Such exposure could occur from a nuclear disaster or from treatment of a previous cancer, like thyroid cancer or Hodgkin's lymphoma. However, the vast majority of people treated for cancer with radiation DO NOT go on to develop leukemia. It takes many years to develop leukemia from this cause.
Symptoms
Chronic myelogenous leukemia is characterized by a chronic phase that can last for months or years. The disease may have few or no symptoms during the chronic phase. Eventually, the chronic phase progresses to a more dangerous "accelerated phase," during which the leukemia cells grow more quickly.
Acceleration of the disease may be associated with fever (without infection), bone pain, and an enlarged spleen. Within 5 years, in most people, the disease then progresses to a "blast crisis," when there is a very high count of immature white blood cells (leukemia cells). The blast phase of the leukemia is very difficult to treat. Bleeding and infection may occur due to bone marrow failure.
Other possible symptoms include:
- Fatigue
- Weakness
- Excessive sweating (night sweats)
- Low-grade fever
- Pressure under the left ribs from an enlarged spleen
- Bleeding and bruising
- Sudden appearance of small red marks on the skin (petechiae)
Signs and tests
A physical examination often reveals an enlarged spleen.
- A CBC shows increased white blood cell count.
- A CBC differential is consistent with increased numbers of white blood cells, either mature or immature (depending on whether the disease is in the chronic or blast phase).
Additional signs and tests include:
Frequently asked questions
What is chronic myelogenous leukemia (CML)?
Chronic myelogenous leukemia is a malignant cancer of the bone marrow. It causes rapid growth of the blood-forming cells (known as myeloid precursors) in the bone marrow, peripheral blood, and body tissues.
What are the risk factors for chronic myelogenous leukemia (CML)?
The disease can occur in adults (usually middle-aged) and children. CML affects 1 to 2 people per 100,000 and accounts for 7-20% cases of leukemia. It is usually associated with a chromosome abnormality called the Philadelphia chromosome. Exposure to ionizing radiation is one possible trigger for this chromosome abnormality. Such exposure could occur from a nuclear disaster or from treatment of a previous cancer, like thyroid cancer or Hodgkin's lymphoma. However, the vast majority of people treated for cancer with radiation DO NOT go on to develop leukemia. It takes many years to develop leukemia from this cause.
What are the symptoms of chronic myelogenous leukemia (CML)?
Chronic myelogenous leukemia is characterized by a chronic phase that can last for months or years. The disease may have few or no symptoms during the chronic phase. Eventually, the chronic phase progresses to a more dangerous "accelerated phase," during which the leukemia cells grow more quickly. Acceleration of the disease may be associated with fever (without infection), bone pain, and an enlarged spleen. Within 5 years, in most people, the disease then progresses to a "blast crisis," when there is a very high count of immature white blood cells (leukemia cells). The blast phase of the leukemia is very difficult to treat. Bleeding and infection may occur due to bone marrow failure.
Written and revised by
Gerald Hurowitz, M.D.
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