Thursday, July 6, 2023

Chronic Myeloid Leukemia (CML)

 Chronic myeloid leukemia (CML) is a malignancy that affects the leukocytes and typically has a protracted course spanning several years. Although it can manifest at any stage of life, it predominantly afflicts elderly individuals aged 60-65 years[1].

 

Causes and Risk Factors

Chronic myeloid leukemia (CML) arises from a genetic mutation in the stem cells that originate from bone marrow. This alteration prompts an overproduction of immature white blood cells while simultaneously decreasing the number of other blood cell types, including red blood cells[1]. Notably, smoking habits, dietary patterns, chemical exposure or infections do not appear to influence one's susceptibility to CML. Furthermore, there is no familial predisposition towards this type of leukemia[2].

 

Symptoms of CML

The indications and manifestations of CML have a tendency to progress gradually. Individuals experiencing such symptoms frequently report sensations of debility, weariness, nocturnal perspiration, weight loss, feverishness, ostealgia, an enlarged spleen as well as sensitivity and inflammation in the left part of their abdominal region[3][1][4]. A multitude of signs and symptoms associated with CML arise because leukemia cells supplant normal blood-producing cells within the bone marrow; consequently individuals affected by CML generate insufficient red blood cells or proficient white blood cells along with platelets[3].

 

Phases of CML

To assist physicians in treatment planning and prognostication, Chronic Myelogenous Leukemia (CML) is categorized into three distinct phases: chronic, accelerated, or blast[5][6]. The earliest stage of CML is the chronic phase which typically presents with less than 10% blasts in both blood and bone marrow[6]. In contrast, the accelerated phase features between 10-19% blasts in both blood and bone marrow or more than 20% basophils in peripheral blood[5]. Finally, blast crisis - also known as acute phase - represents the most advanced form of CML characterized by more than 20% blasts present within either blood or bone marrow[5].

 

Diagnosis

The majority of individuals diagnosed with CML are typically identified through a complete blood count (CBC) prior to exhibiting any symptoms. The CBC quantifies the quantity of distinct cell types within the bloodstream and is frequently performed as part of a routine medical examination. Patients afflicted with CML often exhibit elevated levels of white blood cells[7]. To confirm a diagnosis, healthcare professionals utilize an array of tests to scrutinize both blood and bone marrow cells. A pathologist, who specializes in identifying diseases by analyzing cells under a microscope, will evaluate both the blood and bone marrow cell samples[8].

 

 Treatment of CML

The treatment for chronic myeloid leukemia (CML) is contingent upon the phase of the ailment and the patient's overall wellbeing. The majority of CML patients undergo daily oral drug therapy, such as tyrosine kinase inhibitors (TKIs) [9]. Since TKI therapy's inception in 2001, CML has evolved from a life-threatening malady to a controllable persistent state for most individuals. Patients with CML are living longer while experiencing fewer treatment-related side effects[9]. Additional therapeutic alternatives may include interferon therapy, chemotherapy, radiation therapy, surgery, and stem cell transplantation[10].

 

If you or an acquaintance has recently received a diagnosis of chronic myeloid leukemia, it is vital to pursue assistance and knowledge. The American Cancer Society and the Leukemia & Lymphoma Society extend resources and aid for patients as well as their loved ones.

 

Citations:

[1] https://www.nhs.uk/conditions/chronic-myeloid-leukaemia/

[2] https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/causes-risks-prevention/risk-factors.html

[3] https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/detection-diagnosis-staging/signs-symptoms.html

[4] https://www.lls.org/leukemia/chronic-myeloid-leukemia/signs-and-symptoms

[5] https://www.cancer.net/cancer-types/leukemia-chronic-myeloid-cml/phases

[6] https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/detection-diagnosis-staging/staging.html

[7] https://www.cancer.net/cancer-types/leukemia-chronic-myeloid-cml/diagnosis

[8] https://www.lls.org/leukemia/chronic-myeloid-leukemia/diagnosis

[9] https://www.lls.org/leukemia/chronic-myeloid-leukemia

[10] https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/about/what-is-cml.html

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