Description

Chronic myelogenous leukemia, also called the LMC , is a rare type of cancer of the bone marrow. The bone marrow is the spongy tissue inside bones where blood cells are made. CML causes an increase in the number of white blood cells in the blood.

The term "chronic" in chronic myeloid leukemia means that the cancer tends to progress more slowly than the severe forms of leukemia. The term "myelogenous" (my-uh-LOHJ-uh-nus) refers to the type of cells affected by this type of cancer.

Chronic myelogenous leukemia can also be called myeloid leukemia and chronic granulocytic leukemia chronic. Usually affects older adults and rarely occurs in children, although it can occur at any age.

Advances in treatment have improved the prognosis of patients with chronic myeloid leukemia. The majority of people can achieve remission and live for many years after diagnosis.

Symptoms

Chronic myelogenous leukemia often causes no symptoms. Could be detected during a blood test.

When symptoms do occur, they may include:

  • Pain in the bones.
  • Bleeding easily.
  • Feeling full after eating a small amount of food.
  • Fatigue.
  • Fever.
  • The loss of weight without trying.
  • Loss of appetite.
  • Pain or feeling of fullness below the ribs on the left side.
  • The excessive sweating during sleep.
  • Blurred vision caused by bleeding in the back of the eye.

When to see a doctor

Make an appointment with your health care provider if you have any persistent symptoms that worry you.

Causes

Chronic myelogenous leukemia that occurs when something causes changes in the cells of the bone marrow. It is not clear what initiates this process. However, doctors have discovered how it progresses in chronic myelogenous leukemia.

A new chromosome develops

Human cells usually have 23 pairs of chromosomes. These chromosomes hold the DNA that contains the instructions that tell cells what to do. In people with chronic myeloid leukemia, the chromosomes in the cells of the blood exchange sections with each other. A section of chromosome 9 switches places with a section of chromosome 22. This creates an extra-short chromosome 22 and one extra-long chromosome 9.

The extra-short chromosome 22 is called the Philadelphia chromosome. It is named for the city where it was discovered. The Philadelphia chromosome is present in the cells of the blood of the 90% of people with chronic myeloid leukemia.

The Philadelphia chromosome creates a new gene

The Genes of chromosome 9 are combined with the genes of the chromosome 22 to create a new gene called BCR-ABL. The BCR-ABL gene tells the blood cells that produce too much of a protein called tyrosine kinase. The tyrosine kinase promotes the cancer, allowing certain blood cells to grow out of control.

The new gene allows too many sick of the blood cells

Blood cells begin to grow in the bone marrow. When the functions of the bone marrow properly, produces immature cells, called stem cells of the blood, in a controlled manner. These cells mature and specialize in the red blood cells, white blood cells, and platelets that circulate in the blood.

In chronic myeloid leukemia, this process does not work correctly. The tyrosine kinase allows too many white blood cells to grow. The majority, or all, of these cells containing the Philadelphia chromosome. The disease of white blood cells do not grow and die, as you should. The disease of white blood cells accumulate in large quantities. They crowd healthy blood cells and damage the bone marrow.

Risk factors

The factors that increase the risk of chronic myelogenous leukemia include:

  • Advanced age . Chronic myelogenous leukemia is more common in older people than in children and adolescents.
  • The fact of being a man . Men are slightly more at risk of developing CML women.
  • The exposure to radiation . Radiation therapy for certain types of cancer has been linked to the LMC .

There is no way to prevent chronic myelogenous leukemia. If you do get it, there's nothing you could have done to prevent it.

The family history is not a risk factor

The change in the gene that leads to chronic myelogenous leukemia is not transmitted from parents to children. This change is thought to develop after birth.

Diagnosis

Tests and procedures used to diagnose chronic myelogenous leukemia include:

  • Physical exam. Your health care provider will examine and check the vital signs such as blood pressure and pulse rate. Your provider will also feel your lymph nodes, the spleen, and the abdomen for swelling.
  • Blood tests. A blood sample is extracted with a needle. The sample is sent to a laboratory for a complete blood count, also called CBC. A CBC checks the number of different types of cells in the blood. Chronic myelogenous leukemia often causes a very high number of white blood cells. Blood tests can also measure the function of the organ, to see if something is not working properly.
  • The bone marrow test. Bone marrow biopsy and bone marrow aspiration are used to collect bone marrow samples for the test. The bone marrow has a solid and a liquid. In a bone marrow biopsy, a needle is used to collect a small amount of solid tissue. In a bone marrow aspiration, a needle is used to remove a sample of fluid. The samples are usually taken from the hip bone. Samples of going to a lab for analysis.
  • Tests to look for the Philadelphia chromosome. Specialized tests are used to analyze the blood or bone marrow samples to detect the presence of the Philadelphia chromosome or the BCR-ABL gene. These tests may include fluorescence in situ hybridization analysis, also called FISH, and the polymerase chain reaction test, also called PCR.

Phases of chronic myelogenous leukemia

The phase of chronic myeloid leukemia refers to the aggressiveness of the disease. Your health care provider determines the phase by measuring the proportion of diseased cells from healthy cells of the blood or bone marrow. A greater proportion of diseased cells means that the chronic myelogenous leukemia is in a more advanced stage.

Phases of chronic myelogenous leukemia include:

  • Chronic. The chronic phase is the earliest stage and, in general, has the best response to treatment.
  • Accelerated. The acceleration phase is a transition phase, when the disease becomes more aggressive.
  • The explosion. The burst phase is an aggressive disease of the phase that it becomes life-threatening.

Treatment

The goal of the chronic myelogenous leukemia treatment is to remove the blood cells containing the BCR-ABL gene. For most people, the treatment begins with the targeted therapy that can help achieve long-term remission of the disease.

Targeted therapy

Targeted therapy uses drugs that attack specific chemicals in cancer cells. By blocking these chemicals, the targeted therapy may cause cancer cells to die. In chronic myeloid leukemia, the goal of these medications is of the tyrosine kinase activity of the protein produced by the BCR-ABL gene. Medicines called tyrosine kinase inhibitors, also known as Itc.

The itc are the initial treatment for persons with a diagnosis of chronic myeloid leukemia. Side effects of these drugs targeted include inflammation or swelling of the skin, nausea, muscle cramps, fatigue, diarrhea, and rashes on the skin.

Blood tests to detect the presence of the BCR-ABL gene was used to monitor the effectiveness of the targeted therapy. If the disease does not respond or become resistant to targeted therapy, health care providers may consider other targeted therapy drugs, or other treatments.

Health care providers have not determined a safe point in people with chronic myeloid leukemia can stop taking drugs targeted. For this reason, most people continue to take targeted drugs, even when blood tests show the remission of the disease. In certain situations, you and your provider might consider the possibility of stopping treatment with certain medications, after discussing the benefits and risks.

Bone marrow transplantation

A bone marrow transplant, also called a stem cell transplant is the only treatment that can cure chronic myelogenous leukemia. However, it is generally reserved for people who have not been helped by other treatments. That is because the bone marrow transplants are at risk and lead to a high rate of serious complications.

During a bone marrow transplant, taking high doses of chemotherapy drugs are used to kill the hematopoietic cells in the bone marrow. Then, the blood stem cells from a donor are infused into the bloodstream. The new way of healthy cells from the blood into the cells to replace the diseased cells.

Chemotherapy

Chemotherapy uses strong drugs to kill cancer cells. Chemotherapy drugs are sometimes combined with targeted therapy for aggressive treatment of chronic myelogenous leukemia. Medication side effects of chemotherapy depend on the drugs you are taking.

Clinical trials

Clinical trials are studies of new treatments. These studies provide an opportunity to test the latest treatments. The risk of side effects may not be known. Ask your health care provider if you may be able to be in a clinical trial.

Alternative medicine

There are alternative medicines that have been found to treat chronic myelogenous leukemia. But alternative medicine may help you cope with the fatigue, which is common in people with chronic myeloid leukemia.

You may experience fatigue as a symptom of his disease, a side effect of treatment or as part of the stress that comes with living with a chronic illness. Your health care provider can treat fatigue by controlling the underlying cause, but sometimes the medications alone are not enough.

You can find relief through alternative therapies, such as:

  • Exercise.
  • Write in a journal.
  • The massage.
  • Relaxation techniques.
  • Yoga.

Talk with your doctor about your options. Together you can come up with a plan to help deal with the fatigue.

Lifestyle and home remedies

For many people, chronic myeloid leukemia is a disease that is going to live for years. Many are going to continue the treatment with the targeted therapy indefinitely. Some days, you may feel sick, even if you don't look sick. And some days, you may be sick of cancer. Try these self-care measures to help you to adapt to and cope with a chronic illness:

  • Talk with your health care provider about its side effects. Potent medicine for cancer can cause many side effects. The side effects can often be managed with other drugs or treatments. You do not have to manage without help.
  • Don't stop treatment on your own. If you develop side effects, such as skin rash or fatigue, do not stop taking your medicines without talking to your health care provider. Also, do not stop taking your medication if you feel better and think that your illness may have disappeared. If you stop taking the medication, your condition may come back quickly, even if you have been in remission.
  • Ask for help if you are having trouble coping. Having a chronic illness can be emotionally overwhelming. Tell your doctor about your feelings. Ask for a referral to a counselor or other specialist with whom you can talk.

Coping and support

Facing a serious illness can make you feel worried. With time, you will find ways to cope with your feelings, but you can find solace in these strategies:

  • Learn enough about the chronic myelogenous leukemia to make decisions about your care.The term "leukemia" can be confusing because it refers to a group of cancers that affect the bone marrow and the blood. Do not miss the time of collection of information that does not apply to your type of leukemia. Ask your health care team to write out information about your specific condition. Narrow your search and only find trusted, reliable sources, such as the Leukemia and Lymphoma Society.
  • Stay connected with friends and family. Your cancer diagnosis can be stressful for friends and family. Try to keep your involvement in your life. Your friends and family will probably ask if there is anything I can do to help you. Think about the tasks that you would like to help, such as taking care of your house if you have to stay in the hospital, or simply listen to when you want to talk. You can find comfort in the support of a group that cares for your family and friends.
  • Find someone to talk to . Find someone to talk to, who has experience in helping people facing a life-threatening illness. Ask your healthcare provider to suggest a counselor or a medical social worker can talk. For support groups, contact the American Cancer Society or ask your health care team about the local groups.

Learn enough about the chronic myelogenous leukemia to make decisions about your care. The term "leukemia" can be confusing because it refers to a group of cancers that affect the bone marrow and the blood. Do not miss the time of collection of information that does not apply to your type of leukemia.

Ask your health care team to write out information about your specific condition. Narrow your search and only find trusted, reliable sources, such as the Leukemia and Lymphoma Society.

Stay connected with friends and family . Your cancer diagnosis can be stressful for friends and family. Try to keep your involvement in your life.

Your friends and family will probably ask if there is anything I can do to help you. Think about the tasks that you would like to help, such as taking care of your house if you have to stay in the hospital, or simply listen to when you want to talk.

You can find comfort in the support of a group that cares for your family and friends.

Preparing for your appointment

Start by making an appointment with your primary care provider if you have any symptoms that worry you. If blood tests or other procedures and tests that suggest leukemia, your doctor may refer you to a specialist in the treatment of blood and bone marrow diseases and conditions, called a hematologist.

Because appointments can be brief, and because there's often a lot to discuss, it is a good idea to be prepared. Here's some information to help you prepare, and what to expect from your doctor.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements you are taking.
  • Consider the possibility of a family member or friend. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write questions to ask their health care provider.

Your time with your doctor is limited, so preparing a list of questions to help you make the most of their time together. The list of questions from most important to least important in case time runs out.

For chronic myelogenous leukemia, some basic questions to ask your provider include:

  • Can you explain why my test results mean?
  • Do you recommend other tests or procedures?
  • What is the stage of my CML?
  • What are my treatment options?
  • What side effects are likely to be with each treatment?
  • How will the treatment affect my daily life?
  • What treatment options do you think are the best for me?
  • How likely is it that I'm going to achieve remission with the treatment that you recommend?
  • When do I have to make a decision about my treatment?
  • Should I get a second opinion from a CML specialist? What will that cost, and will my insurance cover it?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?

In addition to the questions that you've prepared to ask, please do not hesitate to ask other questions that occur to you.

What to expect from your doctor

Your health care provider is likely to ask a series of questions. Be ready to answer them may allow time later to cover other points you want to address. Your provider may ask:

  • When did you first begin experiencing symptoms?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Chronic myelogenous leukemia