Chronic Myeloid Leukemia
Chronic myeloid leukemia (CML), also called chronic myelogenous leukemia, is a type of blood cancer that affects a specific type of white blood cell, the myelocytes. This type of leukemia is caused when sections of two different chromosomes in your genes switch places and make a new abnormal one. This new chromosome causes your body to make abnormal cells, which crowd out the healthy cells and cause leukemia.
CML Overview and Symptoms
Chronic myeloid leukemia affects the same cells as acute myeloid leukemia, however AML progresses quickly (within weeks or a few months), while CML develops very slowly over years. A patient may have CML for a long time before symptoms are noticed. Over time, however, CML can change and become acute. About 10% of leukemia cases are chronic myeloid leukemia.
Chronic Myeloid Leukemia (CML) Evaluation and Diagnosis
CML diagnosis generally includes:
- a physical exam
- blood tests and evaluation
- radiology imaging for the evaluation and staging of your leukemia, such as a PET/CT scan. The PET/CT hybrid scanner is a state-of-the-art diagnostic imaging system that provides more precise information and localization for many cancers; and does it quicker than conventional PET imaging.
- biopsy — either a bone marrow biopsy to examine blood cells, or a surgical or CT-guided biopsy to obtain lymph node tissue samples. Usually biopsy procedures are not carried out at the initial visit, but arranged for a later date, once we have gathered your other information and imaging.
Leukemia Multidisciplinary Conference
At BIDMC, we review all of your information with the full blood cancer treatment team in our weekly multidisciplinary conferences. Our radiologists report on your imaging studies and our hematopathologists pathologists who specialize in blood diseases) review the results of your biopsy. Hematologists, oncologists and radiation oncologists voice their opinions. Together as a team focused solely on you, we reach agreement on the best treatment options for your particular situation.
The specific chronic myeloid leukemia treatment you receive will depend on the sub-type of CML you have, how far it has progressed when CML treatment starts, how the CML responds to initial treatment, and other factors. It may include:
- Chemotherapy – the use of chemicals, through one or more types of medication, to treat disease. Chemotherapy interferes with cancer cells’ ability to grow. It can be administered intravenously (through an IV), subcutaneously (an injection below the skin), or orally (as a pill to swallow)
- Targeted therapy – the use of medications to target the specific gene mutations present in your chronic lymphocytic leukemia
- Stem cell transplant – also called bone marrow transplant, in this procedure a donor's stem cells are transfused into your blood. The transplanted stem cells go from your blood to your bone marrow. Through this process, the cells that produced the abnormal cells are replaced with healthy cells that produce normal blood cells.
Types of bone marrow/stem cell transplants:
- Autologous stem cell transplants , which are stem cells that come from your own bone marrow or blood. Doctors extract stem cells from your blood or bone marrow, place them in frozen storage, and re-infuse them back into your body following high-dose chemotherapy to eliminate blood cancers.
- Allogeneic stem cell and bone marrow transplants , which are stem cells that come from matched related donors (siblings, for example), or from matched unrelated donors or donated umbilical cords. As a recognized site of the National Marrow Donor Program, BIDMC has access to an international registry of more than 5 million possible unrelated donors.
Dedicated Stem Cell Lab
Our stem cell/immunotherapy laboratory is a key component of our bone marrow transplantation service. The stem cell lab:
- Excels in the special and meticulous handling of human cells
- Provides expertise in the collection, storage, and manipulation of bone marrow and stem cell products so they are ready to be transplanted (re-infused) into the patient
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