Chronic myelogenous leukaemia (CML) is also known as chronic myelocytic leukaemia, chronic myelosis leukaemia and chronic myeloid leukaemia. It usually occurs from 30 to 50 years of age. The incidence is higher in men as compared to women. Chronic myelogenous leukaemia is a myeloproliferative disorder characterised by excessive production of mature and well-differentiated myeloid cells. It is associated with a chromosomal abnormality, known as the Philadelphia (Ph) chromosome. The early phase of chronic myelogenous leukaemia is asymptomatic that does not behave like a malignant disease and is usually discovered during a routine examination. This phase of chronic myelogenous leukaemia usually proceeds to the accelerated phase that may progress to the blast crisis, after several years. Chronic myelogenous leukaemia usually presents with fatigue, night sweats and low-grade fever due to the hypermetabolic state of the body induced by overproduction of the white blood cells. There may be weight loss, lethargy, tiredness and loss of appetite. The enlarged spleen and liver may lead to abdominal pain and discomfort. There may be tenderness in the bones due to the expansion of the bone marrow. Leukostasis may occur leading to blurred vision and respiratory distress. In the accelerated phase of the chronic myelogenous leukaemia, there may be fever (without infection), bone pain and splenomegaly. In blast crisis of the chronic myelogenous leukaemia, there may occur bone marrow failure leading to infections and bleeding.
In the chronic phase of the chronic myelogenous leukaemia, there are less than 5 per cent immature cells (blast cells) and promyelocytes in the bone marrow. In the accelerated phase of the chronic myelogenous leukaemia, there are 5 to 30 per cent blasts in the bone marrow. In the blastic phase of the chronic myelogenous leukaemia, there are more than 30 per cent blasts in the bone marrow or the peripheral blood. In the meningeal phase of the chronic myelogenous leukaemia, there is involvement of the central nervous system. Procedures used in diagnosis & evaluation of the chronic myelogenous leukaemia include a complete blood count and bone marrow biopsy.
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