What is chronic myelogenous leukemia?

Chronic myelogenous leukemia (CML) is a cancer of the blood in which too many granulocytes, a type of white blood cell, are produced in the bone marrow.

Normally, bone marrow cells mature into several different types of blood cells. CML affects the young blood cells (called blasts) that develop into a type of white blood cell (called granulocytes). The main function of granulocytes is to destroy bacteria. The blasts, which do not mature and become too numerous, remain in the bone marrow and blood.

Chronic myelogenous leukemia can occur over a period of months or years. A specific chromosome rearrangement is found in patients with CML. Part of chromosome #9 breaks off and attaches itself to chromosome #22, so that there is an exchange of genetic material between these two chromosomes. This rearrangement changes the position and functions of certain genes, which results in uncontrolled cell growth. Other chromosome abnormalities can also be present.

According to the American Cancer Society, of the 33,440 leukemia cases expected in 2004 about 15,750 will be acute. AML will account for 11,920 of the acute cases in 2004.

What are the symptoms of chronic myelogenous leukemia?

The following are the most common symptoms of chronic myelogenous leukemia. However, each individual may experience symptoms differently. Symptoms may include:

• anemia
• bleeding
• bruising
• fever
• persistent weakness
• fatigue
• aches in bones and joints
• swollen lymph nodes

The symptoms of chronic myelogenous leukemia may resemble other blood disorders or medical problems. Always consult your physician for a diagnosis.

How is chronic myelogenous leukemia diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for chronic myelogenous leukemia may include:

• additional blood tests and other evaluation procedures
• bone marrow aspiration and biopsy - a procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.
• spinal tap/lumbar puncture - a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes the brain and spinal cord.

Treatment for myelogenous leukemia

Specific treatment for chronic myelogenous leukemia will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• stage of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment may include:

• chemotherapy
• radiation therapy
• treatment for complications, such as infection or anemia
• leukapheresis - a procedure to remove excess lymphocytes from the body.
• bone marrow transplantation
• splenectomy - surgery to remove the spleen