Chronic Myeloid Leukemia

What is chronic myeloid leukemia?

Chronic myeloid leukemia is also called chronic myelogenous leukemia or CML. It is cancer of the bone marrow and blood cells. With CML, blood cells that should become white blood cells (WBCs) do not fully grow. These cells do not fight infection like a normal WBC should. They crowd the bone marrow and prevent normal blood cells from growing and fighting infection.

What causes CML?

The cause is sometimes unknown. It may be caused by exposure to high amounts of radiations or changes in DNA. CML if more common among adults, but it may occur in children too. It is more common among males and people between 50 and 60 years of age.

What are the signs and symptoms of CML?

You may have no signs or symptoms. Many people learn that they have CML after blood is drawn for tests during a regular medical exam. If you have signs and symptoms, they may include one or more of the following:

  • Pain or a full feeling in your stomach

  • Tiredness and weakness that does not go away

  • Fever or infections, such as cold or flu, do not get better or keep coming back

  • Weight loss

  • Shortness of breath, or you become easily tired during exercise

  • Night sweats or sweating more than usual

  • Bone pain, bruising and bleeding

What are the phases of CML?

  • Chronic phase: People with chronic phase CML have few signs and symptoms. The CML cells are in the blood and bone marrow, but have not spread to other parts of the body. This is usually the easiest phase to treat.

  • Accelerated phase: People in this phase have more signs and symptoms. They have more CML cells in their blood and bone marrow. Usually, the CML cells have not spread to other parts of the body.

  • Blast phase: People in this phase have many more CML cells in their blood and bone marrow. The CML cells have usually spread to other parts of the body such as the spleen and liver. CML may be growing faster.

How is CML diagnosed?

  • Blood tests: You will need blood tests to count the number of each type of blood cell (RBCs, WBCs, platelets).

  • Bone marrow biopsy: During this procedure, a small amount of bone marrow is taken from the bone in your hip. This test helps caregivers to learn which phase of CML you have.

How is CML treated?

You and your caregiver will decide which treatment is best for you. Your treatment may be changed if it is not working. You may need one or more of the following treatments:

  • Medicines:

    • Kinase inhibitors: This may help decrease the growth of CML cells and increase the growth of normal blood cells.

    • Chemotherapy: This medicine is also called chemo. It is used to kill cancer cells. It may be used together with other CML medicines or added as a treatment if your cancer has spread. You may also need it before a stem cell transplant.

    • Interferon: This medicine may decrease the growth of CML cells.

  • Radiation: This is a treatment that uses x-rays or gamma rays to kill cancer cells. You may have radiation treatments if the CML cells have spread to body organs such as your spleen and liver. They may be used to treat bone pain caused by CML. You may have radiation treatments before a bone marrow transplant or stem cell transplant.

  • Bone marrow or stem cell transplant: During a transplant, bone marrow or stem cells are put in your blood through an IV. The bone marrow or stem cells should go to your bone marrow and begin to make healthy, new blood cells.

What are the risks of CML?

  • hemotherapy and medicines used to treat CML may cause unpleasant side effects. Some common side effects are nausea, vomiting, and diarrhea. You may feel very tired and have extra body fluid. You could have a bad reaction to a bone marrow transplant or stem cell transplant. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.

  • Treatment of CML may be slow to work, or may not work at all. CML may not go away or it may get worse. If your CML goes into remission, it may return. CML may also spread to other parts of your body. If you do not have treatment, or the treatment does not work, you could die.

Where can I find support and more information?

  • The Leukemia & Lymphoma Society Inc.
    1311 Mamaroneck Avenue
    White Plains , NY 10605
    Phone: 1- 914 - 949-5213
    Phone: 1- 800 - 955-4572
    Web Address: http://www.leukemia-lymphoma.org
  • American Cancer Society
    250 Williams Street
    Atlanta , GA 30303
    Phone: 1- 800 - 227-2345
    Web Address: http://www.cancer.org
  • National Cancer Institute
    6116 Executive Boulevard, Suite 300
    Bethesda , MD 20892-8322
    Phone: 1- 800 - 422-6237
    Web Address: http://www.cancer.gov

Contact your caregiver if:

  • You have blood in your spit or vomit.

  • You are coughing or have shortness of breath.

  • You feel dizzy or your heart begins to beat very fast.

  • You have sores or white patches in your mouth or throat.

  • You have rectal pain or hemorrhoids.

  • You have diarrhea or bloody bowel movements.

  • You have pain in your eyes, ears, skin, joints, or stomach.

  • You have pain when you urinate or bad-smelling urine.

  • Your gums and nose are bleeding.

  • You have blurred vision or blood spots in the whites of your eyes.

  • You have questions or concerns about your condition or care

Seek care immediately or call 911 if:

  • You have a headache, stiff neck, or have trouble seeing or thinking clearly.

  • You are taking chemotherapy or have had chemotherapy in the last two weeks and you have a fever.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

  • You suddenly feel lightheaded and short of breath.

  • You have chest pain. You may have more pain when you take a deep breath or cough. You may cough up blood.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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