Chronic Myelogenous Leukemia

Chronic Myelogenous Leukemia may also be referred as chronic myeloid leukemia and CML.  CML is one of the four most common types of leukemia.  All leukemias are cancers of the bone marrow and blood.

Bone Marrow

The bone marrow is where blood cells are produced.  In the marrow immature cell are produced and begin to mature through stages and as they mature the size of the cell becomes smaller.

Maturation stages of the 5 types of White Cells

When a lab tech reviews a slide of a patient they are looking at the cells in the peripheral blood that has been drawn from your vein.  Under the microscope in a normal patient all the cells will be small ,but an abnormal patient the white cells when viewed under the microscope will be large and small because immature cells will also be seen.

Myelogenous Leukemia in Peripheral Blood Smear

In order to be diagnosed a bone marrow biopsy will have to be performed.  Please view the posted on bone marrow aspiration on this blog site.  The oncologist will perform the biopsy and will be sent to the lab for analysis. They bone marrow will be sent to pathology, special hematolgy and cytogenetics for testing .  For pathology the bone marrow will be stained and the pathologist will review the cells under the microscope and evaluate the bone marrow production.  In CML there will be a abnormal , increased production of granulocytes in the bone marrow.  The reason that they are termed granulocytes is because when viewed under the microscope that appear to have granules in the cell.  This includes neutrophils, basophils and eosinophils.

In Special Hematology they will perform a flow cytometry.  This procedure is where cells are suspended in stream of fluid and the cells and and chromosomes by passing them by an electronic apparatus to identify the cells.
In the genetic testing they will need to find out if there is a chromosomal translocation in the Philadelphia chromosome which is a characteristic of CML.

Symptoms of CML are the following:

1. weight loss
2. malaise
3. hip and joint pain
4. susceptible to infections
5. low grade fever
6. abnormal platelet count

If you are experiencing any of these symptoms you need to see a healthcare professional.
CML is treated with inhibitors of tyrosine kinase such as Gleevec.

The prognosis for CML is good if the patient is pro-active in taking medications and regular visits to the their oncologist.