Chronic myelogenous leukemia (CML) is an uncommon type of cancer of the bone marrow -the spongy tissue inside bones where blood cells are made. CML causes an increased number of white blood cells in the blood.

The term "chronic" in chronic myelogenous leukemia indicates that this cancer tends to progress more slowly than acute forms of leukemia. The term "myelogenous" (my-uh-LOHJ-uh-nus) in chronic myelogenous leukemia refers to the type of cells affected by this cancer.

Chronic myelogenous leukemia can also be called chronic myeloid leukemia and chronic granulocytic leukemia. It typically affects older adults and rarely occurs in children, though it can occur at any age.

Symptoms

Chronic myelogenous leukemia often doesn't cause signs and symptoms. It might be detected during a blood test.

• Bone pain
• Easy bleeding
• Feeling full after eating a small amount of food
• Feeling run-down or tired
• Fever
• Weight loss without trying
• Loss of appetite
• Pain or fullness below the ribs on the left side
• Excessive sweating during sleep (night sweats)

Risk factors

Factors that increase the risk of chronic myelogenous leukemia:

• Older age
• Being male
• Radiation exposure, such as radiation therapy for certain types of cancer

Diagnosis

• Physical exam
• Blood tests
• Bone marrow tests
• Tests to look for the Philadelphia chromosome

Treatment

The goal of chronic myelogenous leukemia treatment is to eliminate the blood cells that contain the abnormal BCR-ABL gene that causes the overabundance of diseased blood cells. For most people, treatment begins with targeted drugs that may help achieve a long-term remission of the disease.

Targeted drug therapy

Targeted drugs are designed to attack cancer by focusing on a specific aspect of cancer cells that allows them to grow and multiply. In chronic myelogenous leukemia, the target of these drugs is the protein produced by the BCR-ABL gene — tyrosine kinase.

Targeted drugs that block the action of tyrosine kinase include:

• Imatinib (Gleevec)
• Dasatinib (Sprycel)
• Nilotinib (Tasigna)
• Bosutinib (Bosulif)
• Ponatinib (Iclusig)

Targeted drugs are the initial treatment for people diagnosed with chronic myelogenous leukemia. Side effects of these targeted drugs include swelling or puffiness of the skin, nausea, muscle cramps, fatigue, diarrhea and skin rashes.

Bone marrow transplant

A bone marrow transplant, also called a stem cell transplant, offers the only chance for a definitive cure for chronic myelogenous leukemia. However, it's usually reserved for people who haven't been helped by other treatments because bone marrow transplants have risks and carry a high rate of serious complications.

Chemotherapy

Chemotherapy is a drug treatment that kills fast-growing cells in the body, including leukemia cells. Chemotherapy drugs are sometimes combined with targeted drug therapy to treat aggressive chronic myelogenous leukemia. Side effects of chemotherapy drugs depend on what drugs you take.

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