What is Chronic Myelogenous Leukemia?

Chronic myelogenous leukemia is an uncommon type of cancer that usually occurs during or after middle age. It is usually a slowly progressing disease of the white blood cells in the bone marrow. Bone marrow is the spongy tissue found inside your bones. In larger bones like the skull, spine, breastbone, ribs or legs, bone marrow contains cells that produce white blood cells, red blood cells and platelets. White blood cells help fight infection. Red blood cells carry oxygen and nutrients and platelets enable the blood to clot. In chronic myelogenous leukemia, abnormal and undeveloped white blood cells grow too quickly and don’t work as they should.

Chronic myelogenous leukemia is usually caused by a chromosome mutation known as the “Philadelphia chromosome.”  This mutation is the result of breakage in two chromosomes. The pieces of each come together and make a new, abnormal chromosome in the DNA of a white cell. There are medications that target this mutation and there are tests for this mutation that can be used to monitor the disease.

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of chronic myelogenous leukemia. We provide supportive programs with specially trained staff including dietitians, social workers, genetic counselors, nurse navigators, financial counselors and psychologists. Plus, we are active in leukemia clinical trial enrollment and membership.

You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Sometimes chronic myelogenous leukemia may be present but cause no or very few symptoms. Some symptoms include:

• Easy bleeding
• Feeling run-down
• Fever
• Unexplained weight loss
• Loss of appetite
• Pain or fullness below the ribs on the left side
• Pale skin
• Night sweats

Diagnosis

To determine if someone has chronic myelogenous leukemia, we ask about medical history and do a physical exam. We also use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Blood test: Blood tests to check the type and number of blood cells and possibly for gene mutations in cells

Bone marrow test: During this test, a local anesthetic may be used to numb the area where the sample of bone marrow will be taken, typically from the hip bone. A small incision is made and a thin, hollow needle is placed into the bone to collect a small portion of marrow to examine for cancer cells and gene mutations.

Fluorescence in situ hybridization test (FISH): Cells from the blood or from the bone marrow can be examined using this test to look at the genes and DNA.

Causes

The causes of chronic myelogenous leukemia are unknown.

Risk Factors

Risk factors that can contribute to chronic myelogenous leukemia include:

Age: Most cases are found in people over the age of 40.

Being male: Men are slightly more likely to develop chronic myelogenous leukemia than women.

Radiation exposure: High dose radiation exposure can increase the risk of chronic myelogenous leukemia. Exposure to radiation treatment for cancer does not increase the risk of chronic myelogenous leukemia.

Prevention 

Risk factors cannot be controlled. Chronic myelogenous leukemia is not an inherited condition. It is not affected by lifestyle habits nor can it be caught from someone.

Prognosis

Although it is hard to get rid of chronic myelogenous leukemia entirely, many people live long lives with treatment and regular follow-up.

Treatment and Recovery

The goal of treatment of chronic myelogenous leukemia is to eliminate as many of the blood cells that contain the abnormal gene and allow healthy cells to grow. It is generally not possible to eliminate all of those cells, but treatment can result in long-term remission of the disease. Remission is when the cancer is less active. Treatment depends upon how advanced the disease is, and can include:

Drug therapy using specially designed drugs that target specific aspects of cancer cells to prohibit the cells from growing. Once remission occurs, these drugs are usually still required to keep the cancer cells from coming back.

Stem cell transplant in which high doses of chemotherapy are given first to kill the leukemia cells and suppress the immune system. Healthy stem cells, usually from a family member or matched donor, are then infused into your blood stream to replace the diseased cells in your bone marrow.

Chemotherapy uses special drugs designed to kill cancer cells. Chemotherapy for chronic myelogenous leukemia is typically given as a pill and often combined with other treatments.

Immunotherapy is the use of an immune substance designed to target the cancer and help the body’s natural immune system to fight the cancer.

Complications

Sometimes, the medications used to treat chronic myelogenous leukemia can cause side effects. It is very important to take all medication as directed, but side effects should be reported as soon as possible. Your doctor and nurses can try several options if there are side effects or if you have trouble tolerating the medications. In addition, because chronic myelogenous leukemia and its treatment may cause fewer healthy red blood cells, white blood cells and platelets, there are a number of other complications that can result. These include:

Anemia: Too few healthy red blood cells can cause fatigue and shortness of breath.

Neutropenia: Too few functioning, normal white blood cells results in an immune system unable to fight infections.

Thrombocytopenia: Too few platelets result in an increased risk of bruising and bleeding.