What is chronic myeloid leukemia?

Chronic myeloid leukemia (CML) is type of cancer in which the bone marrow makes too many white blood cells. In CML, young white blood cells grow abnormally, and they don't mature or die off as they should. These abnormal cells can crowd out normal blood cells and cause problems.

CML usually gets worse slowly. But sometimes it changes into a fast-growing acute leukemia. This is called a blast crisis.

CML often doesn't cause symptoms. When it does, they may include tiredness (fatigue), a feeling of fullness below the ribs, fever, weight loss, and loss of appetite. If the disease gets worse, it may lead to infections, easy bruising or bleeding, and belly or bone pain.

Your doctor will ask about your past health, your family history, and any symptoms you've had. The doctor will do a physical exam and check to see if your lymph nodes or spleen is enlarged.

You'll have tests, which may include:

• Lab tests, including a complete blood count.
• Tissue tests, such as a bone marrow aspiration and biopsy.
• Genetic tests that look for changes in your genes and chromosomes.

If the results point to leukemia, you may have other tests to find out more about the type of leukemia and how severe it is.

CML is treated right away. Treatments may include:

• Targeted therapy with a tyrosine kinase inhibitor.
• Stem cell transplant.
• Medicines, including chemotherapy and corticosteroids.

A clinical trial may be a good choice.

For newly diagnosed people in the beginning stages of CML (chronic phase), targeted therapy with a tyrosine kinase inhibitor may work for many years. If they don't have a relapse, they may never need to have a stem cell transplant. But if they have a relapse or don't respond to targeted therapy, they may need other treatment, including a stem cell transplant.

For people who are diagnosed with CML in the later stages (accelerated or blast crisis phase), treatment may involve targeted therapy by itself. Or it may involve targeted therapy, chemotherapy, and other medicines before having a stem cell transplant.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss.
• Get some physical activity every day, but do not get too tired.
• Get enough sleep, and take time to do things you enjoy. This can help reduce stress.
• Think about joining a support group. Or discuss your concerns with your doctor or a counselor.
• If you are vomiting or have diarrhea:
  • Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
• Avoid infections such as COVID-19, colds, and the flu. Wash your hands often. Get a pneumococcal vaccine. If you have had one before, ask your doctor whether you need another dose. Get a flu shot every year. Stay up to date on your COVID-19 vaccines.
• Do not smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.