CHRONIC MYELOCYTIC LEUKEMIA

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General Illness Information

Common Name:

Leukemia, Chronic Myelocytic

Medical Term:

None Specified

Description:

A stem cell in the bone marrow becomes cancerous, and produces a large number of abnormal white cells, called granulocytes.

May affect any age and sex, but uncommon under the age of 10.

Causes:

Unknown

Prevention:

Cannot be prevented.

Signs & Symptoms

	No symptoms in early stages.
	Later, causes the following:
	Weakness and fatigue.
	Loss of appetite
	Weight loss
	Bleeding
	Enlargement of the spleen.
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Risk Factors

	Risk factors listed in point form, beginning with a capital letter
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Diagnosis & Treatment

Diagnosis is made by examination of the blood film. Bone marrow studies are necessary to confirm the diagnosis. 95 % of patients have a characteristic abnormality of the 22nd chromosome-the Philadelphia chromosome.
General Measures:
	The usual goal of treatment is palliation, not cure. In general, symptoms and physical findings are directly related to the WBC count; therefore, maintenance of a total WBC count of less than 25,000/mL generally helps prevent symptoms.
	Splenectomy may alleviate abdominal discomfort, improve thrombocytopenia, and relieve transfusion requirements when splenomegaly cannot be controlled with chemotherapy or irradiation. There is no evidence that splenectomy plays a significant role during the chronic phase of CML. Radiation to the spleen may help in reducing spleen size.
	The only chance of a cure is bone marrow transplantation.
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Medications:
	Hudroxyurea and other myelosuppressive drugs help to keep the patient in remission, by keeping the white cell count under 50,000.
	Recently, Interferon Alpha has been shown to normalize the bone marrow, and bring about remission.
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Activity:
No restrictions, unless the patient is in blast crisis, or is suffering from serious infection.

Diet:
	No restrictions.
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Possible Complications :
	Accelerated phase or blast crisis.
	Overwhelming infection.
	Anemia
	Severe bleeding
	Severe splenic enlargement
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Prognosis

Ph-negative CML and chronic myelomonocytic leukemia have a worse prognosis than Ph-positive CML. Except for cases in which bone marrow transplantation can be used successfully, treatment is not curative.

Of patients, 5 to 10% die within 2 yr of diagnosis, and 10 to 15% die each year thereafter; 90% of deaths follow a blast crisis or an accelerated phase of the disease. Median survival after blast crisis is about 2 mo but can be extended to about 8 to 12 mo if remission is achieved.

Other

'Nothing Specified'.