Understanding Chronic Myeloid Leukaemia (CML)

A Comprehensive Guide for Patients

Oncology

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Last updated: Mar 24, 2025

What is CML?

Chronic Myeloid Leukaemia (CML) is a type of blood cancer that affects the white blood cells. It develops when the bone marrow produces too many abnormal white blood cells called granulocytes.

Key Characteristics

  • Slow-growing cancer (chronic)
  • Presence of Philadelphia chromosome (BCR-ABL fusion gene)
  • Most common in adults over 60
  • Accounts for ~15% of all leukaemias

Phases of CML

1. Chronic Phase

  • Initial phase where most patients are diagnosed
  • Often asymptomatic or mild symptoms
  • Good response to treatment

2. Accelerated Phase

  • Disease progression
  • More symptoms appear
  • Harder to control with treatment

3. Blast Phase

  • Most advanced stage
  • Resembles acute leukaemia
  • Requires aggressive treatment

Common Symptoms

  • Fatigue and weakness
  • Unexplained weight loss
  • Night sweats
  • Fever
  • Enlarged spleen (may cause abdominal discomfort)
  • Easy bruising or bleeding

Diagnosis

  • Blood tests
  • Bone marrow biopsy
  • Genetic testing for Philadelphia chromosome
  • Regular monitoring of BCR-ABL levels

Treatment Options

Targeted Therapy

  • Tyrosine kinase inhibitors (TKIs)
    • Imatinib
    • Nilotinib
    • Dasatinib

Other Treatments

  • Chemotherapy (if TKIs ineffective)
  • Stem cell transplantation
  • Clinical trials

Living with CML

Monitoring

  • Regular blood tests
  • PCR testing for BCR-ABL levels
  • Follow-up appointments

Lifestyle Recommendations

  • Maintain a healthy diet
  • Regular exercise as tolerated
  • Adequate rest
  • Infection prevention

Support and Resources

  • Medical team support
  • Patient support groups
  • Psychological support
  • Financial counseling

Prognosis

  • Excellent survival rates with modern treatments
  • Many patients achieve long-term remission
  • Regular monitoring essential

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