Chronic Myeloid Leukemia: Who’s At Risk, and What Are the Signs?

    chronic myeloid leukemia

    Chronic myeloid leukemia (CML) is a blood cancer that affects about 200,000 new people each year. This difficult-to-treat disease starts with a change in certain blood-forming bone marrow cells’ chromosomes. Once these chromosomal DNA changes occur, your bone marrow starts producing too many abnormal white blood cells called granulocytes. (These abnormal granulocytes are also known as leukemia cells.) You’ll also start accumulating immature white blood cells (called “blasts”) in your bone marrow as well as your blood.

    Over time, this abnormality makes it harder for you to produce normal platelets, white blood cells and red blood cells. Anemia can occur if you don’t have enough red blood cells to carry sufficient oxygen throughout your body. This leads to heart problems, including irregular heartbeat, chest pains and poor circulation. Too few platelets make it harder for your blood to clot, so you easily bruise and bleed. Without enough healthy white blood cells, you’ll struggle to fight off infections and communicable diseases. CML is a progressive blood and bone marrow disease that mostly affects middle-aged individuals and occurs rarely in children.

    What Makes Philadelphia Positive Chronic Myeloid Leukemia (Ph+ CML) Different?

    Doctors diagnose over 90% of CML patients with a genetic mutation that’s known as the “Philadelphia chromosome.” This Philadelphia gene abnormality causes DNA from chromosomes 9 and 22 to break off and switch places with each other. These so-called “fusion genes” located inside your cells contain a tyrosine kinase protein called BCR-ABL. This BCR-ABL hybrid protein is always turned on, which tells your CML cells to start dividing uncontrollably.

    From there, the leukemia cells divide almost continuously, building up in your bone marrow and eventually invading your bloodstream. Both chronic myeloid leukemia and Ph+ CML are slow-growing cancers, but successful treatment gets harder as the disease progresses. Luckily, this Philadelphia chromosome mutation isn’t inherited, so Ph+ CML patients cannot pass it on to their children.

    Chronic Myeloid Leukemia Risk Factors

    There are just a few known CML risk factors, including:

    • Radiation exposure. Exposure to high-dose radiation increases your risk for developing any cancer, including chronic myeloid leukemia.
    • Age. Most people don’t develop CML until middle age, or sometime after their 40th birthday. Doctors rarely diagnose chronic myeloid leukemia or Ph+ CML cases in children.
    • Gender. Men are slightly more likely to develop CML than women, but the reason why is unclear.

    Chronic Myeloid Leukemia Symptoms

    Many CML patients appear asymptomatic because any existing signs and symptoms are mild. The way you’ll probably learn you have CML is a blood test with an unusually high white blood cell count. In most cases, CML symptoms result from secondary health complications due to abnormally high white blood cell production. Some more recognizable CML symptoms may include:

    • Weakness
    • Fatigue
    • Night sweats
    • Fever
    • Weight loss (potentially due to lack of appetite)
    • Bone and/or joint pain
    • An enlarged spleen
    • Pain or “fullness” in the belly
    • Cold hands as well as feet
    • Enlarged spleen

    How to Get a Chronic Myeloid Leukemia Diagnosis

    Getting any kind of cancer diagnosis can be terrifying. Most people learn they have chronic myeloid leukemia or Ph+ CML from blood tests run during their routine annual physical. To confirm your diagnosis, your doctor will likely do a bone marrow biopsy and send those samples to a lab. Once the lab confirms they’ve found leukemia cells, you’ll likely undergo genetic testing for the Philadelphia chromosome DNA mutation, too.

    Because CML is a bone marrow and blood cell cancer, your doctor won’t assign a stage for your disease. Instead, your doctor will classify your CML prognosis using three distinct groups called phases. These phases indicate how many immature white blood cells currently exist within your blood or bone marrow. These three chronic myeloid leukemia phases are:

    • Chronic – indicates that immature white blood cells comprise less than 10% of patient’s blood or bone marrow samples. Symptoms (if any) are mild, and patients usually respond well to standard treatments.
    • Accelerated – immature white blood cells make up 10%-20% of patient’s blood or bone marrow samples, or leukemia cells show new chromosome changes. In some cases, accelerated phase patients show very high or low platelet counts or high blast counts that don’t respond to treatment.
    • Acute phase/blast crisis – blasts comprise more than 20% of patient’s blood or bone marrow samples and are spreading to other tissues and organs.

    Doctors diagnose most CML cases during the chronic phase. However, your disease phase also determines how your oncologist will treat your CML or Ph+ CML.

    How Tasigna Treats Chronic Myeloid Leukemia

    Targeted therapies are among the most common CML and Ph+ CML treatments currently available. Because most CML cells contain the BCR-ABL tyrosine kinase protein, your oncologist will likely prescribe a tyrosine-kinase inhibitor drug (TKI). The standard TKIs most doctors prescribe for treating CML and Ph+ CML are:

    • Gleevec (imatinib) – the standard first-line treatment among all TKIs, Gleevec effectively treats any CML phase. Doctors recommend most patients who achieve CML remission with Gleevec keep taking the drug indefinitely. Gleevec can cost $100,000 annually and increases risk for cardiovascular problems, but patients can also apply for prescription discount programs.
    • Tasigna (nilotinib) – Effectively treats chronic-phase CML, but studies show 25%-33% of Tasigna patients stop taking it due to serious cardiovascular health issues.

    How Tasigna Patients With Heart Problems Can Get Justice and Compensation

    Medical studies link Tasigna to serious cardiac issues, including coronary artery disease, heart attacks, stroke and sudden death. However, Tasigna’s manufacturer, Novartis, failed to include any cardiovascular risks on the drug’s packaging and warning labels. As a result, Tasigna patients who experienced cardiac events are filing failure to warn and negligence claims against Novartis AG.

    If you or someone you love had serious heart problems while taking Tasigna, you may qualify for a cash settlement. To find out if you may qualify immediately online, fill out your Tasigna claim review form now. Once you’ve submitted your information, an advocate will reach out to discuss your case and explain your compensation options.

    Mandy Voisin

    Mandy Voisin is a freelance writer, blogger, and author of Girls of the Ocean and Star of Deliverance. As an accomplished content marketing consultant, mom of four and doctor's wife, Mandy has written hundreds of articles about dangerous drugs and medical devices, medical issues that impact disabled Americans, veterans' healthcare and workers' compensation issues since 2016.

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