Chronic Myeloid Leukemia
What is Chronic Myeloid Leukemia (CML)?
Chronic myeloid leukemia (CML) is the third-most common leukemia in children. It is much more common in adults. This slow-moving cancer occurs when excessive numbers of bone marrow stem cells develop into white blood cells and crowd out other cells that produce red blood cells and platelets in the bone marrow. Often, patients are diagnosed when they have few or no symptoms but are undergoing blood tests done for other reasons.
CML always is associated with the Philadelphia chromosome, a mutation of genetic material that results in the over production of white blood cells.
What are the symptoms of CML?
- Bone/joint pain
- Easy bruising or bleeding
- Fatigue and weakness
- Fever with or without infection
- Pain or feeling of fullness below the left ribs due to enlarged spleen
How is CML diagnosed?
A number of diagnostic tests are used to determine whether or not a patient has CML. These tests may include a complete blood count (CBC), bone marrow aspiration and biopsy, and lumbar puncture.
How is CML treated?
Treatment for CML includes targeted drugs known as tyrosine kinase inhibitors that turn off the action of the abnormal genetic material causing overproduction of white blood cells found in CML. These drugs include imatinib (Gleevec) and newer ones such as dasatinib (Sprycel) and nilotinib (Tasigna). Oral chemotherapy may be used initially to reduce very high white blood cell counts.
When the blood counts return to normal, the patient is considered to have achieved clinical remission. The blood and occasionally bone marrow are monitored to determine the effectiveness of treatment. Bone marrow transplant or stem cell transplant may be performed if the patient does not respond adequately to the chemotherapy.
Can patients with CML experience a relapse?
CML may recur in the blood, bone marrow, or other parts of the body. Stem cell transplantation is considered for patients whose disease returns after treatment with a tyrosine kinase inhibitor. Long-term cure after transplantation ranges from 60 percent to 80 percent.
About treatment for CML at Children's
Children's hematology/oncology program consistently achieves treatment results ranking it as one of the top ten programs in the U.S. Children's treats the majority of children with cancer and blood disorders in Minnesota and provides patients with access to a variety of clinical trials of groundbreaking new treatments. Through our renowned leukemia/lymphoma program, patients experience unparalleled family support, a nationally renowned pain management team, and compassionate, coordinated care.
If you are a family member looking for a Children's hematologist or oncologist or wanting to schedule an appointment, please call our clinic at Children's – Minneapolis at (612) 813-5940.
If you are a health professional looking for consultation or referral information, please call Children's Physician Access at 1-866-755-2121 (toll-free) and ask for the on-call hematologist/oncologist.