Chronic myeloid leukemia: living with a controlled disease
For most patients CML is now a long-term condition controlled with daily tablets. Monitoring is what keeps it that way.
Chronic myeloid leukemia is driven by a single genetic event: an exchange between chromosomes 9 and 22 that creates the Philadelphia chromosome and the BCR-ABL1 fusion gene. The protein it produces switches on white cell production and keeps it on.
Because the cause is so specific, CML became one of the first cancers treated with a targeted tablet, and it changed the outlook of the disease more than almost any other development in hematology.
How CML is Found
Many patients have no symptoms, and CML is discovered on a routine blood count showing a high white cell count. Others notice tiredness, weight loss, night sweats or a feeling of fullness under the left ribs from an enlarged spleen.
The diagnosis is confirmed by finding the BCR-ABL1 gene in the blood with a PCR test, and a bone marrow examination shows the phase of the disease.
Tyrosine Kinase Inhibitors
Treatment is a daily tablet that blocks the BCR-ABL1 protein. Several drugs of this class exist, and the choice depends on the patient's other illnesses, side effects and the risk profile of the disease.
Response is measured with a quantitative PCR test every few months. The targets are clear and time-based, and failing to reach them is a reason to check adherence, test for resistance mutations and consider switching to another drug.
Stopping Treatment and the Role of Transplant
For patients who reach and keep a deep molecular response for several years, carefully monitored discontinuation of treatment is now possible, and a proportion of them stay in remission without tablets.
Bone marrow transplantation, once the standard cure for CML, is today reserved for the minority whose disease resists several inhibitors or progresses to an advanced phase.
Have your case reviewed
Send your blood counts, bone marrow and pathology reports, genetic results and a summary of previous treatment. Dr. Uzay's team will come back to you with the next step.
WhatsApp: +90 537 954 65 84This article is for general information only and does not replace a medical examination or personalized medical advice.