Chronic Myeloid Leukaemia (CML)

What is Chronic Myelogenous Leukemia?

Chronic myelogenous Leukemia (CML) is also known as chronic myeloid leukemia is a form of blood cancer that develops in the bone marrow, which is the tissue that is responsible for the production of blood cells. This disease causes the excessive production by abnormal cells which slowly outnumber healthy ones.

CML is a condition that typically affects people of middle age or older and can progress through various stages as time passes. With the help of modern therapies numerous patients can remain healthy for a long time without a problem.

How CML Develops

CML stems from a distinct genetic disorder called CML is a result of a genetic abnormality known as Philadelphia the chromosome. It is caused by an interlocutory transfer (swap) between the parts of the chromosomes 9 and 22 leading to a fusion genetics called BCR-ABL1.. The gene causes cells increase in size and expand without control, forming white blood cells that are leukemic.

Symptoms of CML

The symptoms can differ based on the severity of the disease. It can be difficult to detect in the beginning stages. Common symptoms include:

• Persistent fatigue

• Unexplained weight loss

• Night sweats

• The possibility of bleeding or bruising is very easy.

• Affections are not a problem.

• Spleen is enlarged (causing abdominal pain or a feeling of fullness)

• Infections that are frequent

• Joint or bone pain

As the disease progresses the symptoms get more severe because of the decline in normal blood cells.

Phases of CML

CML is a progressive disease that occurs through three phases:

1. Chronic Phase:

   • Leukemia cell lines are in existence, but can be controlled

   • Often no major symptoms

   • The best time to begin treatment

2. Accelerated Phase:

   • Rapid growth in cells that are abnormal

   • The more obvious symptoms

   • The disease becomes more difficult to control

3. Blast Phase (Blast Crisis):

   • The high number of cells that are immature (blasts)

   • The symptoms can get more severe

   • Reminisces of acute leukemia, and requires urgent medical attention

Diagnosis of CML

To detect CML and to determine the stage It is recommended to perform the following tests commonly conducted:

• Complete Blood Count (CBC): Measures different levels of blood cells

• Bone Marrow Biopsy: Assesses cell composition within the bone marrow

• Genetic Testing: Detects the BCR-ABL1 gene (via FISH testing or PCR)

• Image (Ultrasound and CT scan): Checks spleen size

Treatment for Chronic Myelogenous Leukemia

The principal goal of CML therapy is decrease the amount of abnormal cells as well as prevent progress of the disease.

Tyrosine Kinase Inhibitors (TKIs)

TKIs target the BCR ABL protein and have revolutionized CML treatment. The oral medications can aid patients stay in remission for a long time:

• Imatinib (Gleevec)

• Dasatinib (Sprycel)

• Nilotinib (Tasigna)

• Bosutinib (Bosulif)

• Ponatinib (Iclusig) – used in cases where other TKIs are not working.

• Omacetaxine (Synribo) for cases with resistance

Stem Cell Transplant

If patients do not respond to medications or go to advanced levels treatment, an stem cell transplant (also known as an organ transplant using bone marrow) may be a viable cure. A suitable donor is needed typically a close family member or a compatible non-related donor.

Other Therapies

• Interferon alpha: It is a possibility to use it in specific circumstances, notably during pregnancy.

• Chemotherapy Sometimes, it is used blast or advanced phases.

Living with CML

The management of CML is an ongoing commitment. Monitoring blood tests regularly and genetic analyses helps to ensure that treatment is effective. A lot of patients stay in remission for a long time.

Self-Care & Follow-Up

• Follow the prescribed treatment plan

• Inform your doctor about any adverse effects or medication interactions

• Keep a healthy and balanced diet, and remain physically active to the extent can be tolerated

• Avoid infections and attend all follow-up visits with your hematologist-oncologist

Outlook

While CML can be a long-lasting disease however, it is extremely manageable particularly when it is detected in its chronic stage. With constant advances in targeted treatments and treatments, the long-term outlook of patients suffering from CML is becoming more positive.