General Illness Information
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.
Prevention: Cannot be prevented.
Signs & Symptoms
No symptoms in early stages.
Later, causes the following:
- Weakness and fatigue.
- Loss of appetite
- Weight loss
- Enlargement of the spleen.
- Chromosome abnormalities
- Radiation exposure
- Immunodeficiency states
- Chemical and drug exposure (nitrogen mustard and benzene)
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.
- 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.
- 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.
No restrictions, unless the patient is in blast crisis, or is suffering from serious infection.
- Accelerated phase or blast crisis.
- Overwhelming infection.
- Severe bleeding
- Severe splenic enlargement
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.