Posts Tagged ‘Chronic myelogenous leukemia’

Staging for Chronic Myelogenous Leukemia

Because leukemia starts in the bone marrow and often has spread to other organs by the time it is detected, there is no need for traditional staging. All leukemias are classified according to their genotypes, or their unique chromosomal arrangements, which also enables the physicians to determine risk factors.

Staging for Chronic Myelogenous Leukemia (CML)

CML is divided into 3 groups that help predict outlook. Doctors call these groups phases instead of stages. The phases are based mainly on the number of immature white blood cells – myeloblasts (“blasts”) — that are seen in the blood or bone marrow.

Chronic Phase
- Patients in this phase typically have less than 10% blasts in their blood or bone marrow samples.
- These patients usually have fairly mild symptoms (if any) and usually respond to standard treatments.

Accelerated Phase
Patients are considered to be in accelerated phase if any of the following are true:
- The bone marrow or blood samples have more than 10% but fewer that 20% blasts.
- High blood basophil count (basophils making up at least 20% of the white blood cells).
- Increased white blood cell counts that do not go down with treatment
very high or very low platelet counts that are not caused by treatment
new chromosome changes in the leukemia cells.

Blast Phase
- Bone marrow and/or blood samples from a patient in this phase have more than 20% blasts.
- The blast cells often spread to tissues and organs beyond the bone marrow. These patients often have fever, poor appetite, and weight loss.

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Chronic myelogenous leukemia (CML) – Overview

Chronic myelogenous (or myeloid) leukemia (CML), also known as chronic granulocytic leukemia (CGL), is a cancer of the white blood cells. It is a form of leukemia characterized by the increased and unregulated growth of predominantly myeloid cells in the bone marrow and the accumulation of these cells in the blood.

Causes and Risk factors

Children of parents with CML do not have a greater risk of developing the disease. There is a question as to whether radiation used for treatment raises the risk of CML. No infectious agents are linked to the development of this leukemia.

Symptoms

During the early stages of CML most people do not have any symptoms of the disease. When symptoms do develop they include:
– Tiredness that will not go away.
– Unexplained weight loss.
– Fever.
– Shortness of breath.
– Night sweats.
– Abdominal pain from a swollen spleen.
– Poor appetite.
People who have any of these symptoms should consult with their doctor. None of these symptoms prove that a person has cancer or leukemia and a true diagnosis can be made only by a trained oncologist or hematologist.

Phases of CML

CML is divided into three phases depending on the maturity of the leukemia WBCs.
- Chronic phase
There are mostly mature leukemia WBCs in the blood and bone marrow and there may be no symptoms of leukemia. This phase lasts from several months to several years, with an average duration of five years.
- Accelerated phase
There are some immature leukemia WBCs in the blood and bone marrow (between 5 percent and 30 percent). Patients may have fever, poor appetite and weight loss. The leukemia cells may have new chromosome changes, in addition to the Philadelphia chromosome.
- Acute phase
It is also called blast phase or blast crisis. In this phase, there are mostly immature WBCs in the blood and bone marrow (more than 30 percent). Symptoms such as anemia and recurring infections are typical.

How is CML treated?

Treatment options for people with CML depend on the phase of their disease, age and the availability of a potential donor for a bone marrow or blood cell transplant.
- Chemotherapy : It uses drugs to kill cancer cells. These drugs are usually taken by mouth or administered in a vein or into the skin or tissue. Because the drugs circulate in the blood, they can reach leukemia cells all over the body. There are four drugs used in the treatment of chronic phase CML.
- Immune therapy : It uses the body’s immune system to fight cancer. One type used to treat chronic phase CML is interferon alpha, a regulator of the immune system. Interferon alpha is sometimes combined with cytarabine chemotherapy and can be associated with adverse side effects, some of which are severe.
- Bone marrow transplantation : It is used to replace the CML patient’s unhealthy bone marrow (which produces abnormal blood cells) with healthy bone marrow (that can produce normal blood cells).