More About Leukemia

Chronic Myelocytic Leukemia, otherwise known as CML or in its shortened name leukemia, is a cancer caused by a defective bone marrow. It is the bone marrow, particularly the soft and spongy substance located inside it, is responsible in forming blood cells for several body functions. When a person has CML, his bone marrow produces an excessive number of white blood cells.

Who Is At Risk?

This type of cancer chooses no one- it affects people of different walks of life, and different age groups, regardless of gender. About 2 persons in every 100,000 people are affected by CML- that is about 7 to 20 percent on the entirety of all cases of leukemia.

Symptoms Of CML

Aside from the noticeable signs of fatigue in the affected person, patients could also be seen some small red marks on the skin’s surface and the patient is also most likely to feel pressure or slight pain on the left side of the rib cage.

Cause Of Chronic Myelocytic Leukemia – Or CML

CML occurs when the chromosomes in the human DNA gets rearranged. There are two particular chromosomes that forms into a Philadelphia chromosome- this will cause the chromosome to produce tyrosine kinase. This enzyme is the culprit in the abnormal platelet and white blood cell production in the body. This abnormal production, particularly the excessive blood cell production lead to Chronic Myelocytic Leukemia.

Exposure to radiation also causes such abnormality in the chromosomes.

Stages Of CML

With the progression of the disease, the excess white blood cell production is visible in the bone marrow. It will then spread out and enter the bloodstream. There are several changes that leukemia cells will encounter in the process: chronic, accelerated and blast crisis phase. In the chronic phase, the CML is almost unnoticed, however, it will be seen that the patient gets exhausted easily, or for no apparent reason, loss of weight and of appetite, and also excessive sweating, fever and many others. This is because of the enlargement of spleen.

The accelerated phase, on the other hand, is equally dangerous as the last phase because it is the time when the leukemia cells reproduce in huge and uncontrollable numbers. Due to this increase, the patient experienced fevers and other symptoms that could be hazardous to the health.

In the blast crisis phase, the CML becomes worse and the leukemia cells produced are mostly immature. In this phase, the patient’s weight drops dramatically, and the spleen becomes even larger. The patient is also also expected to bruise very easily, and the red blood cells, including the platelets will also drop in great amounts. Because the bone marrow fails in this phase, there would also be other complications, such as series of infections.

Diagnosis Of CML

The patient should be subject to a specific blood count to determine the number of each blood cells – red, white and the platelets. If the tests show an abnormal increase in white blood cells, the patient is to be examined thoroughly- including the taking of the chromosome sample to determine whether or not there is existing Philadelphia chromosome.

Also, the doctor will check if the patient has an enlarged or swelling spleen. Other tests include bone marrow aspiration, genetic testing, platelet count, CBC differential and other tests. These tests are done so the vitamin B12 and uric acid levels of the suspected patient are checked.

Treatment Of CML

One of the measures to follow once the patient is diagnosed with CML is to stop the defective chromosome from making more tyrosine kinase (which is responsible of the abnormal white blood cell production). It is by administering imatinib, otherwise known in its brand name Gleevec.

Other medications are dasatinib, and nilotinib which controls the white blood cell production. Hudroxyurea could also be given to the patient. It is one of the types of medication intended for chemotherapy. These are effective medications for the CML that was detected in its earlier stage.

Aside from medications, bone marrow transplant or stem cell transplant could be very helpful. In the event that a patient opts to have a transplant, he/she should openly discuss various matters with the doctor, particularly with support treatments before and after the transplant. This should be done at the earlier stages, as having transplants done of the blast phase will make the whole treatment ineffective.

Stem cell transplant could be combined with other treatment methods. When the treatment has a combination of chemotherapy medications, particularly a high-dosed one, there will be a great chance to completely eliminate the CML. However, stem cell is a tedious and a very difficult process, as the stem cells from the donor should be exactly the same type of tissue with that of the patient’s. It also has to be performed on the first stage to have greater chances of complete healing.

When the CML is not treated, it is expected that the patient will live only up to a few months. Treatment with imatinib could help extend the patient’s life up to 1 year as well. Other medications previously mentioned such as hudroxyurea and busulfan is good as a relief to the many symptoms that could be seen in CML, but does not extend the survival of the patient.