Leukemia is basically a cancer of the blood. Different forms of leukemia exist, which depends on what sort of blood cell is affected. The term Chronic basically describes the slow progression or a gradual, and the term myeloid represents the origin from myeloid cells, which are more likely immature cells that generally become mature RBC, WBC, or Platelets. In the phase of chronic myeloid leukemia (CML), the bone marrow produces excess myeloid blood cells which are at various maturation stages including cells known as immature granulocytes, myeloblasts, and metamyelocyte. Basophils and platelets are more often overproduced at the time of diagnosis. Excess production of myeloid blood cells in the bone marrow ultimately prevents the normal production of red blood cells, which are important in delivering oxygen to all the cells in the body, and may also decrease the production of thrombocytopenia or platelets. Platelets play a crucial role in order to stop the bleeding.
Chronic Myeloid Leukemia Symptoms: Patients with chronic myeloid leukemia (CML) may be diagnosed at a routine checkup, or after seeking medical care due to lack of energy and fatigue from the anemia, or abdominal pain or discomfort, or bleeding, and rarely bruising from the insufficient platelets. Enlargement of the spleen, called splenomegaly, leads to the left chest and abdominal discomfort, early satiety, or Changement in the bowel patterns. Other possible signs and symptoms include shortness of breath, bone pain, and fever. At diagnosis, most of the patients have a white blood count (the number of white blood cells circulating in the blood) increased above normal.
What are the stages of CML: CML is often divided into three phases. In the case of absence of the intervention, CML typically starts in the chronic phase, and over the course of the progression of several years, it appears in an accelerated phase and ultimately to a blast crisis. Blast crisis phase is the terminal phase of CML and clinically behaves like Acute Leukemia. Early initiation of drug treatment usually stops the progression.
• Chronic Phase
• Accelerated Phase
• Blast Crisis
Chronic Myeloid Leukemia Diagnosis: Diagnosis CML typically presents with leukocytosis, a profound left-shift in WBCs, thrombocytosis, and splenomegaly, although more commonly today is diagnosed on a routine blood test. The differential diagnosis includes other myeloproliferative disorders, chronic myelomonocytic leukemia, and chronic neutrophilic leukemia. The diagnosis of CML is confirmed by demonstration of the Philadelphia chromosome, on bone marrow or peripheral blood samples. This may be achieved by conventional cytogenetics, fluorescence in-situ hybridization (FISH), or polymerase chain reaction (PCR) in either marrow or blood.
What is the best treatment for Chronic Myeloid Leukemia: The treatment should take place only in centers used to treat CML and offering an adequate multidisciplinary infrastructure. Whenever possible, the treatment must be offered in the form of clinical trials. Treatment of CML is tailored to the individuals based on the phase of disease at the time of diagnosis. Unlike rigid tumors, surgical resection and radiation therapy do not serve a role in order to the management of the CML.
• Targeted drug therapy (kinase inhibitors, imatinib mesylate 400 mg)
• Allogeneic stem cell transplant (SCT)
• Chemotherapy (hydroxyurea)
• Clinical trials with new agents
Imatinib (Gleevce): imatinib mesylate 400 mg is the only BCR-ABL tyrosine kinase inhibitor indicated for first-line treatment of CML. It is considered as the standard treatment since FDA approval in 2001. The goal of treatment is to reduce the number of cells containing the Ph chromosome.
Chronic Myeloid Leukemia Symptoms: Patients with chronic myeloid leukemia (CML) may be diagnosed at a routine checkup, or after seeking medical care due to lack of energy and fatigue from the anemia, or abdominal pain or discomfort, or bleeding, and rarely bruising from the insufficient platelets. Enlargement of the spleen, called splenomegaly, leads to the left chest and abdominal discomfort, early satiety, or Changement in the bowel patterns. Other possible signs and symptoms include shortness of breath, bone pain, and fever. At diagnosis, most of the patients have a white blood count (the number of white blood cells circulating in the blood) increased above normal.
What are the stages of CML: CML is often divided into three phases. In the case of absence of the intervention, CML typically starts in the chronic phase, and over the course of the progression of several years, it appears in an accelerated phase and ultimately to a blast crisis. Blast crisis phase is the terminal phase of CML and clinically behaves like Acute Leukemia. Early initiation of drug treatment usually stops the progression.
• Chronic Phase
• Accelerated Phase
• Blast Crisis
Chronic Myeloid Leukemia Diagnosis: Diagnosis CML typically presents with leukocytosis, a profound left-shift in WBCs, thrombocytosis, and splenomegaly, although more commonly today is diagnosed on a routine blood test. The differential diagnosis includes other myeloproliferative disorders, chronic myelomonocytic leukemia, and chronic neutrophilic leukemia. The diagnosis of CML is confirmed by demonstration of the Philadelphia chromosome, on bone marrow or peripheral blood samples. This may be achieved by conventional cytogenetics, fluorescence in-situ hybridization (FISH), or polymerase chain reaction (PCR) in either marrow or blood.
What is the best treatment for Chronic Myeloid Leukemia: The treatment should take place only in centers used to treat CML and offering an adequate multidisciplinary infrastructure. Whenever possible, the treatment must be offered in the form of clinical trials. Treatment of CML is tailored to the individuals based on the phase of disease at the time of diagnosis. Unlike rigid tumors, surgical resection and radiation therapy do not serve a role in order to the management of the CML.
• Targeted drug therapy (kinase inhibitors, imatinib mesylate 400 mg)
• Allogeneic stem cell transplant (SCT)
• Chemotherapy (hydroxyurea)
• Clinical trials with new agents
The first of this new class of drugs was approved by the US FDA in 2001. gleevec 400 mg has the potential in order to inhibit the progression of Chronic Myeloid Leukemia in the majority of patients sufficiently in order to achieve the regrowth of their normal bone marrow stem cell population (a cytogenetic response) with stable proportions of maturing WBC. Because several leukemic cells persist in about all the patients, so the treatment must be continued indefinitely. Since the advent of imatinib (Veenat 100 mg), CML has become first cancer in which a standard medical treatment may give to the patient a normal life expectancy.
Adverse effects: The most common non-hematologic side effects with Veenat 100 mg (imatinib) are fluid retention and edema, nausea, diarrhea, skin rash, and muscle cramps. Most are grades 1-2. Congestive heart failure/LV dysfunction and pleural effusions have been observed, but their association with imatinib is uncertain. Other side effects may include hepatotoxicity, fatigue. Serious adverse effects are very rare. Low dose diuretics can be very useful for edema. For skin rash antihistamines and topical corticosteroids are helpful, and anti-nauseants for nausea.
What are the differences between CLL (Chronic Lymphocytic Leukemia) and CML (Chronic Myelogenous Leukemia)?
Difference between CML and CLL
CLL stands for chronic lymphocytic leukemia is a type of cancer of white blood cells in the bone marrow.
• In the case of CML, myeloid stem cells are involved while in CLL lymphoid B or T cells are affected.
• CML generally occurs to middle age people however CLL affects old age people.
• About 20% of the patients suffering from CML do not show any symptoms while in the case of CLL patients range from 50% who are asymptomatic.
• CML is caused by tyrosine kinase pathway chromosomal translocation however CLL is represented by chromosomal abnormalities by chromosome deletion and possible somatic hypermutation.
• Common symptom of CML is splenomegaly whereas in CLL is lymphadenopathy and hepatosplenomegaly
Other Common Drugs to treat Chronic Myeloid Leukemia: The following list of medications are in some way related to, or used in the treatment of Chronic Myeloid Leukemia.
Hydroxyurea: The hydroxyurea medication is used in chronic myelogenous leukemia. It is recommended to be consumed orally (by mouth).
This antineoplastic family of drug may cause some common side effects include:
- bone marrow suppression
- fevers
- loss of appetite
- psychiatric problems
- shortness of breath
- headaches
This drug comes in the capsule form as the strength of 500 mg. The hydroxyurea 500 mg is believed to act by blocking the making of DNA.
Cytarabine: Cytarabine is a chemotherapy medication used in order to treat chronic myelogenous leukemia (CML). It is recommended to be given by injection into a vein, under the skin, or into the cerebrospinal fluid.
This antimetabolite and nucleoside analog families of drug may cause some common side effects include:
- rash
- bleeding
- vomiting
- diarrhea
- liver problems
- bone marrow suppression
- ulcer formation in the mouth
This drug comes in the form of injection, which is believed to act by blocking the function of the DNA polymerase.
What kind of drug is cytarabine?
The cytarabine 100 mg belongs to the group of medicines named antimetabolites. It works by resisting or blocking the growth of cancer cells.
Note: Before starting any treatment, please consult a physician. In order to know more about any medication, read full prescription information.
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