Chronic Myeloid Leukaemia (CML)

Chronic myeloid leukaemia (CML) is a type of cancer that affects the white blood cells and tends to progress slowly over time. It is characterized by the uncontrolled growth of mature and immature granulocytes, which are a type of white blood cell.

Causes and Risk Factors

The exact cause of CML is not fully understood, but it is associated with a genetic mutation in the BCR-ABL1 gene. This mutation leads to the production of an abnormal protein that promotes the growth and survival of cancer cells. Risk factors for CML include:

• Age: CML can occur at any age, but it is most common in adults over 50 years old
• Exposure to radiation: People who have been exposed to high levels of radiation are at increased risk of developing CML
• Genetic predisposition: Some people may be born with a genetic mutation that increases their risk of developing CML

Symptoms

The symptoms of CML can vary from person to person, but common signs and symptoms include:

• Fatigue and weakness
• Weight loss
• Night sweats
• Pain or discomfort in the left upper abdomen due to an enlarged spleen
• Easy bruising or bleeding
• Recurring infections

Diagnosis

CML is typically diagnosed through a combination of physical examination, medical history, and laboratory tests. These tests may include:

• Complete blood count (CBC): To measure the levels of different types of blood cells
• Bone marrow biopsy: To examine the bone marrow for abnormal cells
• Cytogenetic analysis: To look for genetic mutations, such as the BCR-ABL1 fusion gene
• Polymerase chain reaction (PCR) testing: To detect the presence of the BCR-ABL1 fusion gene

Stages

CML is typically divided into three phases:

• Chronic phase: This is the earliest stage of CML, during which the disease progresses slowly and symptoms may be mild or absent
• Accelerated phase: At this stage, the disease begins to progress more quickly, and symptoms become more severe
• Blast crisis: This is the most advanced stage of CML, during which the disease progresses rapidly and aggressively

Treatment

Treatment for CML usually involves a combination of medications and therapies. These may include:

• Tyrosine kinase inhibitors (TKIs): Such as imatinib, dasatinib, and nilotinib, which target the BCR-ABL1 protein
• Chemotherapy: To kill cancer cells
• Interferon therapy: To stimulate the immune system to attack cancer cells
• Bone marrow transplantation: In some cases, a bone marrow transplant may be necessary to replace damaged bone marrow with healthy tissue

Prognosis

The prognosis for CML has improved significantly in recent years due to the development of effective treatments. With proper treatment, many people with CML can experience long-term remission and live for many years after diagnosis.