Many people who have chronic myeloid leukemia (also known as chronic myelogenous leukemia or CML) do not show symptoms of the disease at first and may be diagnosed only after abnormal results are noticed on a routine blood test. Symptoms will likely become apparent over time, although several symptoms of CML are the same as many other conditions.
CML shares many common symptoms with other types of leukemia. Most of the symptoms occur as a result of abnormal levels of healthy blood cells.
Symptoms of CML include:
When there are too many leukemia cells in the bone marrow, new cells cannot be made. The bone marrow is responsible for making healthy red blood cells, white blood cells, and platelets. Without enough of these blood cells, many problems can develop, including:
Some people with CML may have high levels of abnormal white blood cells or platelets. However, these cells cannot fight infections the way normal, healthy white blood cells and platelets do. This leads to bleeding and infection risk.
There are three phases of CML: chronic phase, accelerated phase, and blast phase (also known as blast crisis phase).
Most cases of CML are diagnosed in the chronic phase. People with chronic phase CML may or may not show symptoms, which can make it difficult to diagnose. It is usually caught during routine blood tests that find an increased number of white blood cells. If left untreated, chronic phase CML can progress to accelerated or blast phase CML.
People with accelerated phase CML will have changes in their blood counts and worsening symptoms. More blasts (immature blood cells) are found in the blood and bone marrow, and symptoms like anemia can worsen. During this phase, CML cells grow faster and can lead to an enlarged spleen (splenomegaly), fatigue, weight loss, and fever. Accelerated phase CML will eventually progress to blast phase CML.
People with blast phase CML present similarly to those with acute myeloid leukemia (AML). Signs and symptoms include:
If you are experiencing any symptoms of CML, talk to your doctor. They will perform several lab tests to confirm a diagnosis. These include blood tests and a bone marrow biopsy.
A complete blood count (CBC) measures the levels of different blood cells, including red and white blood cells and platelets. A blood smear is also done, where a sample of blood is put on a glass slide and looked at under a microscope. In some cases, people with CML will have too many immature cells known as blasts or myeloblasts.
Leukemia begins in the bone marrow, so it is vital to check for cancer cells there. A thin, hollow needle is inserted into the bone and the marrow inside, and samples are taken to be examined under a microscope.
If you’re diagnosed with leukemia and begin treatment, you may also notice side effects that may seem like symptoms.
All medications come with side effects, and it can be difficult to tell the difference between these side effects and symptoms of a condition. CML is commonly treated with tyrosine kinase inhibitors (TKIs), which are a class of drugs that target the abnormal BCR-ABL1 gene found in leukemia cells. These include:
Potential side effects of these TKIs include:
In addition, chemotherapy can be used to treat CML. Chemotherapy drugs can include Hydrea (hydroxyurea), Cytoxan (cyclophosphamide), and Synribo (omacetaxine). Symptoms of CML and side effects of chemotherapy also overlap, including:
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