Chronic myeloid leukemia (also called CML or chronic granulocytic
leukemia) is a disease in which too many white blood cells are made
in the bone marrow. The bone marrow is the spongy tissue inside the
large bones in the body. The bone marrow makes red blood cells
(which carry oxygen and other materials to all tissues of the body),
white blood cells (which fight infection), and platelets (which make
the blood clot). Normally, bone marrow cells called blasts develop
into several different types of blood cells that have specific jobs
to do in the body. CML affects the blasts that are developing into
white blood cells called granulocytes. The blasts do not mature and
become too numerous. These immature blast cells are then found in
the blood and the bone marrow. In most people with CML, the genetic
material (chromosomes) in the leukemia cells have an abnormal
feature called a Philadelphia chromosome. This chromosome usually
doesn't go away, even after treatment. Leukemia can be acute
(progressing quickly with many immature blasts) or chronic
(progressing slowly with more mature-looking cancer cells). Chronic
myeloid leukemia progresses slowly and usually occurs in people who
are middle-aged or older, although it can also occur in children. In
the first stages of CML, most people don't have any symptoms of
cancer. A doctor should be seen if any of the following symptoms
appear: tiredness that won't go away, a feeling of no energy, fever,
not feeling hungry, or night sweats. Also, the spleen (the organ in
the upper abdomen that makes other types of white blood cells and
filters old blood cells from the blood) may be swollen.
If there are symptoms, a doctor may order blood tests to count
the number of each of the different kinds of blood cells. If the
results of the blood test are not normal, the doctor may order more
blood tests. A bone marrow biopsy may also be done. During this
test, a needle is inserted into a bone and a small amount of bone
marrow is taken out and looked at under the microscope. The doctor
can then tell what kind of leukemia the patient has and plan the
best treatment.
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Stages of chronic myeloid leukemia. Once chronic myeloid leukemia
(CML) has been diagnosed, more tests may be done to find out if
leukemia cells have spread into other parts of the body such as the
brain. This is called staging. CML progresses through different
phases and these phases are used to plan treatment. The following
stages are used for chronic myeloid leukemia:
There are few blast cells in the blood and bone marrow and there
may be no symptoms of leukemia. This phase may last from several
months to several years.
There are more blast cells in the blood and bone marrow, and
fewer normal cells.
More than 30 % of the cells in the blood or bone marrow are blast
cells. The blast phase of CML is sometimes called "blast crisis."
Sometimes blast cells will form tumors outside of the bone marrow in
places such as the bone or lymph nodes. Lymph nodes are small
bean-shaped structures that are found throughout the body. They
produce and store infection-fighting cells.
Leukemia cells do not decrease even though treatment is given.
This article is from the PDQ, which is a service of the
National Cancer Institute.
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Contact
The Leukemia & Lymphoma Society
1311 Mamaroneck Ave.
White Plains, NY 10605
or call the
Information Resource Center at (800) 955-4572.
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Helpful Links
- National Cancer Institute
This site offers comprehensive information about cancers and the
diagnosis procedures.
- Medicine Online
This site offers information about diagnosis and treatment
(including immunotherapy), with pages written by several
physicians. Go to "cancer links/leukemia/current" .
The CML Medical Monitor was developed to help people living with
chronic myeloid leukemia keep track of their symptoms and
treatment progress. It was designed in collaboration with CML
medical experts and patients like you.
We want you to get the most you can out of this valuable
resource, so we thought we would highlight some of the features
of the tracking tool. In this issue, we will tell you how to
take advantage of the "Ask the Experts" feature, as well as the
"Education" and "Resources" sections.
Ask the Experts
The "Ask the Experts" section of the CML Medical Monitor enables
you to submit questions about CML to our roster of experts,
which includes leading doctors and nurses in the CML field. You
may also view questions and answers that have previously been
submitted—just click on the question you are interested in. Some
recent questions include queries about lab report information,
and CML medication usage and side effects.
Education and Resources
In the CML Medical Monitor "Education" page, you will find an
ever-growing library of CML information. Our library is a rich
resource featuring educational videos, articles and "Ask Your
Doctor" handouts that will help you learn more about topics
regarding CML. You can print out the "Ask Your Doctor" handouts
and take them with you to the doctor's office. That way you will
have a handy reference that offers a list of suggested
questions, as well as a brief explanation of why knowing the
answers to these questions will help you become a more
knowledgeable and empowered patient.
The "Resources" section offers a list of organizations
devoted to people living with leukemia and/or other kinds of
cancer. Descriptions of each group are included, as well as
links to each organization's Web site.
To see these features in action, you'll first need to log on
to the CML Medical Monitor at:
www.cmlmedicalmonitor.com. Once you're logged in, follow the
links for more on the "Ask the Experts," the "Education," and
the "Resources" features of the CML Medical Monitor. Check back
often as we will continue to update these features.
The CML Medical Monitor is supported through an unrestricted
educational grant from Novartis Oncology.
If you have any questions or comments about the CML Medical
Monitor, please email us at:
info@cmlmedicalmonitor.com.
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