Chronic myeloid leukemia
"In young patients, a bone marrow transplant can be performed if they have a donor".
DR. JOSÉ RIFÓN ROCA
SPECIALIST. HAEMATOLOGY AND HAEMOTHERAPY DEPARTMENT
The chronic myeloid leukemia (CML) is a disease included among the so-called chronic myeloproliferative syndromes, which are characterized by presenting alterations derived from a malignant proliferation of the bone marrow that affects all the hematopoietic series.
Specifically, CML is characterized by a predominant increase in the granulocyte series, responsible for the production of leukocytes.
CML is a common leukemia, accounting for 15% of adult chronic leukemias. The age of presentation is between the third and sixth decades of life, being a rare disease in children and the elderly.
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What are the symptoms of myeloid leukemia?
CML is usually an asymptomatic disease. The disease can be suspected by the alterations that are observed in the analysis.
As it evolves in the time, the gradual appearance of asthenia, anorexia, loss of weight and, typically, some annoyances in the left zone of the abdomen, with sensation of heavy digestions, produced by the great increase of size of the spleen that compresses the stomach and other organs.
The most common symptoms are:
- Loss of weight.
- Sensation of heavy digestions.
Do you have any of these symptoms?
You may have chronic myeloid leukemia
What are the causes of myeloid leukemia?
CML has no defined cause, although some cases have been linked to exposure to ionizing radiation or certain chemicals. Involved in the genesis of CML is the so-called Philadelphia chromosome.
This chromosome is produced as a result of an oncogenic stimulus capable of altering in an unknown way the structure of two chromosomes (9 and 22) that pass from one to another part of their content. Secondarily, an abnormal protein will be produced, responsible for the neoplastic transformation in CML.
What is your prognosis?
Its prognosis has evolved a lot in the next few years due to the fact that there is more and more knowledge about the disease, specifically about leukemia cells, which favors the application of more specific treatments, which are also more effective.
How is chronic myeloid leukemia diagnosed?
Very often the diagnosis of chronic myeloid leukemia is made in the routine analysis, when a large leukocytosis is observed in the hemogram.
With the suspicion of CML, a bone marrow biopsy should be performed. The bone marrow examination should include a genetic study where the existence of the Philadelphia chromosome will be demonstrated.
When CML is suspected, the cytochemical reaction of alkaline granulocyte phosphatase is also performed, which allows the differentiation of leukocytosis produced by CML from those produced by other causes, mainly severe infections.
How is chronic myeloid leukemia treated?
We have a Day Hospital for outpatient treatment of leukemia
CML is developed in three phases. The initial phase, called chronic phase, which over time evolves, previously passing through an acceleration phase, to an acute phase in which CML is transformed into acute leukemia. The treatment will depend on the phase in which the disease is found.
Initially it is done with hydroxyurea (chemotherapy) by mouth and interferon (immunotherapy), trying to control the great leukocytosis. Those patients who are in the phase of acceleration or transformation to an acute leukemia should receive more aggressive treatments. Once the disease has been controlled, the treatment to be followed will depend on the age of the patient.
Young patients with bone marrow donors may be submitted to bone marrow transplantation, since it is the only curative treatment. In older patients or those who do not have a bone marrow donor, a bone marrow autotransplant may be considered.
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