Chronic Myelogenous Leukaemia

What Is Chronic Myelogenous Leukemia? - CML Treatment in India

Chronic myelogenous leukaemia, or CML, is a type of cancer that begins in the blood-forming cells of the bone marrow. This short explains what CML is and how it develops.

What is CML?

CML is a cancer of the white blood cells which usually develops slowly.

• A genetic change. It is caused by a specific genetic mutation in the bone marrow cells, known as the Philadelphia chromosome. This change is acquired during a person's lifetime and is not inherited.
• Slow progression. The disease typically progresses through three phases: chronic, accelerated, and blast. Most people are diagnosed during the chronic phase, when treatment is usually most effective.
• Overproduction of cells. The genetic change causes the bone marrow to produce too many of a type of white blood cell called granulocytes. These abnormal cells build up in the blood and bone marrow.

Symptoms and diagnosis

In its early stages, CML may cause no symptoms and is often discovered during a routine blood test.

• Possible symptoms. When symptoms do occur, they can include tiredness, weight loss, night sweats, and a feeling of fullness or pain on the left side of the abdomen due to an enlarged spleen.
• Blood tests. A diagnosis often begins with a complete blood count (CBC) that shows a very high white blood cell count. A blood smear may show leukaemia cells.
• Bone marrow tests. To confirm the diagnosis, a bone marrow aspiration and biopsy are usually performed. The samples are tested for the Philadelphia chromosome or the related BCR-ABL gene.

How is CML treated?

The main treatment for CML is a type of targeted drug therapy.

• Targeted drugs. Tyrosine kinase inhibitors (TKIs) are the standard treatment. These are daily pills that target the protein created by the BCR-ABL gene, controlling the production of abnormal cells.
• Monitoring treatment. Your response to TKI therapy is monitored with regular blood tests to check for the presence of the BCR-ABL gene. The goal is to achieve a deep and lasting remission.
• Other options. If TKIs are not effective or cause difficult side effects, other treatments such as different TKIs, chemotherapy, or a stem cell transplant may be considered.

The information here is for general guidance. Whether a particular treatment is suitable for you depends on your individual circumstances. A specialist will need to review your medical reports and recent imaging to advise on the best course of action.