Leukemia (Chronic Myelocytic)

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.

Risk Factors

  • Chromosome abnormalities
  • Radiation exposure
  • Immunodeficiency states
  • Chemical and drug exposure (nitrogen mustard and benzene)
  • Preleukemia

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.

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.

Activity:

No restrictions, unless the patient is in blast crisis, or is suffering from serious infection.

Diet:

No restrictions.

Possible Complications:

  • Accelerated phase or blast crisis.
  • Overwhelming infection.
  • Anemia
  • Severe bleeding
  • Severe splenic enlargement

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’.

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