Chronic myeloid leukaemia

About

Chronic myeloid leukaemia (CML) is a type of leukemia that affects the production of white blood cells by the bone marrow. It is caused by a genetic mutation in the bone marrow that causes it to produce abnormal white blood cells known as myeloid cells. Symptoms typically include weakness, weight loss, fever, night sweats and bruising easily. Treatment typically includes medication to suppress the mutation, chemotherapy and/or a stem cell transplant. CML can be fatal if left untreated, but with proper treatment, remission is possible.

Symptoms

The symptoms of Chronic myeloid leukaemia (CML) vary from person to person, but may include:

Fatigue
Fever
Weight loss
Night sweats
Bone/Joint pain
Enlarged lymph nodes
Enlarged spleen
Easy bruising or bleeding
Shortness of breath
Abdominal or chest pain
Frequent infections
Pale skin

Causes

The exact cause of Chronic myeloid leukaemia is not known. However, research suggests certain inherited genetic mutations may be linked to its development. These genetic changes are believed to disrupt the control of cell growth and division, leading to an over-growth of white blood cells in the bone marrow. Other environmental factors, such as smoking, ultraviolet radiation, and exposure to certain chemicals, may also play a role in the development of Chronic myeloid leukaemia.

Risk factors

Chronic myeloid leukaemia (CML) is an uncommon form of cancer that affects the bone marrow and blood. Risk factors associated with CML include:

older age: CML is most common in individuals over the age of 65
genetics: Having certain genetic mutations, including a certain type of mutation known as the Philadelphia chromosome, can increase the risk of CML
radiation exposure: Exposure to radiation, either through medical treatments such as radiation therapy for cancer or exposure to high doses of radiation from accidents or nuclear disasters, can increase the risk of CML
smoking: Smoking can increase the risk of CML
certain chemicals: Exposure to certain types of chemicals, such as benzene, can increase the risk of CML.
infection: Infection with certain viruses, including human T-cell lymphotropic virus (HTLV)-1, has been linked to an increased risk of CML.

Diagnosis

Chronic myeloid leukaemia (CML) is typically diagnosed after a series of tests including a physical exam, blood tests, X-rays, a bone marrow biopsy, cytogenetics tests, and a specific type of genetic test known as a polymerase chain reaction (PCR). During a physical exam, your doctor will take a look at your medical history and do a physical exam to check for signs of CML, such as swollen lymph nodes, fever, or night sweats.

Blood tests will determine if your red and white blood cells and platelets are at a normal level, as well as if your HB% is above or below normal. An X-ray or a scan may be ordered to look for swollen lymph nodes or other abnormalities in the bones caused by CML. A bone marrow biopsy will be done to confirm the diagnosis, as it can reveal if the leukaemia cells are present in your bloodstream.

Cytogenetics tests will look for a specific gene, known as the Philadelphia chromosome, that is linked to CML. Finally, a PCR test will be done to confirm the presence of the gene. Once all of these tests have been done, your doctor will be able to make an accurate diagnosis of CML and create a treatment plan.

Sub-types

Chronic myeloid leukaemia (CML) is a type of cancer that affects the blood and bone marrow. It is a clonal myeloproliferative disorder that results in an overproduction of white blood cells. The disease is caused by the abnormal expression of a gene known as BCR-ABL, which is a result of a chromosomal translocation.

There are three main types of CML: chronic phase, accelerated phase, and blast phase.

Chronic phase CML is the most common type and is characterized by overproduction of mature myeloid cells. The disease progresses slowly and symptoms may not be obvious in the early stages. Common symptoms include fatigue, weight loss, and anemia.
Accelerated phase CML is a more advanced form of the disease, characterized by an increased blast count, anemia, and other signs of the disease progressing more rapidly.
Blast phase CML is the most severe form of the disease and is characterized by a large number of immature myeloid cells known as blasts. Common symptoms of this form of the disease include fever, weight loss, and night sweats.

It is important to note that CML is a treatable form of leukemia and early detection and treatment are key to a successful outcome.

Treatments

Treatment for Chronic myeloid leukaemia (CML) typically includes targeted therapy with tyrosine kinase inhibitors (TKIs) such as imatinib, nilotinib, dasatinib, and bosutinib. Other treatment options may include interferon-alpha, chemotherapy, stem cell transplantation (SCT), and radiolabelled targeted therapy. Many of these treatments work by targeting the genetic mutation that causes CML, known as the Philadelphia chromosome. Depending on the patient’s medical history, age, and other factors, doctors may recommend one or more of these treatments.

Prevention

Avoid contact with known carcinogens, such as radiation, benzene, and insecticides.
Wear protective clothing and gear when exposed to environmental or workplace toxins.
Eat a healthy diet rich in fruits and vegetables and low in red and processed meats.
Avoid smoking and alcohol consumption.
Exercise regularly and maintain a healthy weight.
Get vaccinated against hepatitis B and C viruses.
Get regular medical check-ups and seek medical advice promptly if any symptoms of CML arise.
Seek medical advice promptly if a family member is diagnosed with CML.

Gender differences?

Yes, there are gender-specific differences in the presentation and management of Chronic myeloid leukaemia (CML).

For example, in terms of presentation, males tend to be diagnosed with CML at an earlier age (in their 30s and 40s) than females (who are usually diagnosed in their 50s and 60s). This is thought to be due to a higher prevalence of genetic mutations and changes that can lead to the development of CML in males.

In terms of management, males are more likely to be prescribed tyrosine kinase inhibitors (TKIs) as the first line of treatment, while females are more likely to be prescribed chemotherapy. This is due to the fact that TKIs are more likely to produce successful results in males, while chemotherapy is more likely to produce successful results in females.

Nutrition

Nutrition plays an important role in the management of Chronic myeloid leukaemia (CML). Proper nutrition can help patients maintain their strength and energy levels, which are essential for coping with CML treatment and its side effects. Eating a well-balanced diet including a variety of fruits, vegetables, and whole grains can help patients stay healthy and better manage their symptoms. Patients should avoid processed and fried foods, excessive sugar, alcohol and other stimulants. Eating small, frequent meals helps keep energy levels high throughout the day. In addition to eating a healthy diet, getting adequate rest and exercise are important for managing CML.

Physical Activity

Physical activity has been shown to have a positive effect on patients with Chronic myeloid leukaemia (CML). Regular physical activity helps to reduce fatigue, maintain physical strength, and improve quality of life. Studies have shown that moderate intensity exercise can reduce inflammation, improve cardiovascular health, and improve the efficacy of chemotherapy treatment. Additionally, physical activity can help improve mental health, which is particularly beneficial for CML patients, as they must cope with the psychological ramifications of having a chronic illness. In summary, physical activity has a variety of benefits for patients with CML, and is an important component of a holistic treatment plan.