Chronic myeloid leukaemia

Overview Of Chronic myeloid leukaemia

Chronic myelogenous leukemia (CML) is a rare type of cancer that affects the bone marrow and blood. It is a slowly progressing form of leukemia characterized by the overproduction of abnormal white blood cells. These abnormal cells crowd out healthy blood cells, impairing the immune system and leading to complications such as anemia, bleeding problems, and increased susceptibility to infections. CML is caused by a genetic mutation known as the Philadelphia chromosome, which creates an abnormal gene called BCR-ABL. This gene produces a protein that drives the uncontrolled growth of leukemia cells. While CML primarily affects adults, it can occur at any age. Advances in targeted therapies have revolutionized the management of CML, transforming it from a potentially fatal disease to a manageable chronic condition for many patients.

Causes of Chronic myeloid leukaemia

• The primary cause of chronic myelogenous leukemia (CML) is a genetic mutation that occurs during a person’s lifetime. This mutation is not inherited but develops in the bone marrow cells:
• Philadelphia Chromosome: Nearly all cases of CML are linked to the Philadelphia chromosome, a genetic abnormality resulting from the exchange of genetic material between chromosomes 9 and
• This creates the BCR-ABL gene, which produces an abnormal tyrosine kinase protein. This protein signals the bone marrow to produce too many white blood cells, leading to leukemia.
• Radiation Exposure: High levels of radiation exposure, such as from nuclear accidents or radiation therapy, have been associated with an increased risk of developing CML.
• Unknown Triggers: While the exact factors that lead to the genetic mutation are not fully understood, it is believed to involve a combination of environmental and cellular factors that cause DNA damage in bone marrow cells.

Risk Factors of Chronic myeloid leukaemia

• Several factors increase the risk of developing chronic myelogenous leukemia (CML):
• Age: CML is most commonly diagnosed in middle-aged and older adults, typically around the age of
• Gender: Men are slightly more likely to develop CML than women, although the reasons for this difference are unclear.
• Radiation Exposure: Individuals exposed to high levels of radiation, such as survivors of nuclear accidents or those who have undergone certain types of radiation therapy, may have an increased risk.
• No Family History: Unlike some cancers, CML is not linked to inherited genetic mutations or family history of the disease.

Prevention of Chronic myeloid leukaemia

• There is no definitive way to prevent chronic myelogenous leukemia (CML), as it primarily results from genetic mutations that occur randomly. However, certain steps may help reduce the risk:
• Avoid Radiation Exposure: Limit exposure to unnecessary radiation, such as from medical imaging or occupational sources, whenever possible.
• Healthy Lifestyle: Maintaining overall health and a strong immune system may support the body’s ability to fight diseases, although it may not directly prevent CML.
• Regular Check-Ups: Routine medical exams can help detect abnormalities early, improving treatment outcomes.

Prognosis of Chronic myeloid leukaemia

• The prognosis for chronic myelogenous leukemia (CML) has dramatically improved over the past two decades, thanks to advancements in targeted therapy. Tyrosine kinase inhibitors (TKIs) have transformed CML into a manageable chronic condition for most patients, with many achieving long-term remission. With consistent treatment, life expectancy for CML patients now approaches that of the general population. However, CML is a lifelong condition requiring ongoing treatment and monitoring. Factors influencing prognosis include the phase of the disease at diagnosis (chronic, accelerated, or blast phase), the patient’s response to treatment, and overall health. Early diagnosis and adherence to prescribed therapies are critical for achieving the best outcomes.

Complications of Chronic myeloid leukaemia

• If untreated or poorly managed, chronic myelogenous leukemia (CML) can lead to several complications:
• Disease Progression: CML can progress from the chronic phase to more aggressive phases (accelerated or blast crisis), which are harder to treat.
• Infections: An increased number of abnormal white blood cells disrupt the immune system, making patients more susceptible to infections.
• Anemia and Bleeding Disorders: Low red blood cell and platelet counts can lead to severe anemia, easy bruising, and prolonged bleeding.
• Spleen Rupture: An enlarged spleen may rupture, causing life-threatening complications.
• Treatment Side Effects: Long-term use of TKIs can cause side effects such as fatigue, joint pain, and fluid retention.

Related Diseases of Chronic myeloid leukaemia

• Chronic myelogenous leukemia (CML) is associated with or resembles the following conditions:
• Acute Myeloid Leukemia (AML): A more aggressive form of leukemia that can develop from CML during the blast phase.
• Polycythemia Vera: A blood disorder that leads to the overproduction of red blood cells.
• Essential Thrombocythemia: A condition causing elevated platelet levels, which can lead to clotting or bleeding problems.

Treatment of Chronic myeloid leukaemia

Treatment for chronic myelogenous leukemia (CML) has been transformed by the development of targeted therapies, enabling most patients to manage the disease effectively: 1. **Targeted Therapy**: a. Tyrosine kinase inhibitors (TKIs), such as imatinib, dasatinib, and nilotinib, block the abnormal protein produced by the BCR-ABL gene, halting the progression of leukemia. These medications are often the first-line treatment and can induce long-term remission. 2. **Chemotherapy**: a. Used less frequently due to the success of TKIs, chemotherapy may be employed in advanced cases or in combination with other treatments. 3. **Stem Cell Transplantation**: a. A bone marrow or stem cell transplant may be considered for patients who do not respond to TKIs or for those with advanced disease. This involves replacing diseased bone marrow with healthy donor cells. 4. **Interferon Therapy**: a. Interferon-alpha may be used in certain cases, particularly in patients unable to tolerate other treatments. 5. **Supportive Care**: a. Blood transfusions, medications to manage side effects, and treatments for infections may be necessary to support overall health during treatment.