Diagnosis of chronic myeloid leukemia (CML) - first questions

Diagnosis of chronic myeloid leukemia (CML) - first questions




You have received the diagnosis of CML and may ask: What is this disease, what's next? The article guides you through the offer of information and helps to quickly build up a basic knowledge.

If you have been diagnosed with chronic myelogenous leukemia (CML), there are certainly many questions that arise: What is chronic myeloid leukemia? What treatment options are there? How is it going for me now?
This article provides first information about chronic myelogenous leukemia and related links. At the end of the text, you will also find a printable checklist that will give you clues to talk to your doctor.
What is a chronic myeloid leukemia?

Chronic myeloid leukemia is a rare form of blood cancer [1]. In Germany, around 1,200 people develop CML every year [2]. The term leukemia translates to "white blood." In patients, there is an uncontrolled proliferation of special white blood cells (leucocytes), the so-called granulocytes, in the blood and bone marrow. [3] Diagnosis is often around 500,000 white blood cells in one Millionth of a liter (microliter = μl) of blood before [4]. By comparison, in healthy people, there are 4,000-9,000 white blood cells per microliter of blood [5].

For you to read on:

    Chronic or acute, myeloid or lymphatic - the forms of leukemia

What causes the disease?

In most cases, chronic myeloid leukemia is the result of a change in the genetic material of a hematopoietic stem cell that can occur at any time during life. The consequence of this> mutation is a pathologically altered chromosome, the so-called Philadelphia chromosome. Once this chromosome has been formed, the body can produce a protein that normally does not exist in the human body. This causes the uncontrolled proliferation of white blood cells - it creates a CML. [1,6]

For you to read on:

    The Philadelphia chromosome

Which examinations diagnose CML?

If there is a suspicion of chronic myelogenous leukemia, the doctor will initiate various investigations to clearly diagnose the disease: [2]

    By a physical examination he can z. For example, determine if the spleen is enlarged - this may be an indication of CML.
    As part of a blood test, the blood count is checked for abnormalities that are typical of CML.
    In an examination of the bone marrow, the doctor takes a bone marrow sample and checks which cells are present in which amount. In addition, it is examined whether the disease-typical Philadelphia chromosome is detectable in the bone marrow cells.
    In addition, it can be checked in a blood sample how much of the protein (BCR-ABL) is formed by the Philadelphia chromosome. This value is important later for the control of the treatment success.

Physical examination and blood tests may provide evidence of CML. But only by the bone marrow examinations is a safe differentiation from other blood diseases possible.

For you to read on:

    Check-ups in CML
    If you would like to understand the meaning of your test results, take a look at the Laboratory Values ​​section.



How is a CML going?

In chronic myelogenous leukemia, a distinction is made between three consecutive disease phases. If left untreated, CML progresses through these stages and ultimately leads to death. The phases are called chronic phase, accelerated phase and blast crisis and each have typical characteristics. [6]

For you to read on:

    The CML runs in three phases
    Signs of progression of CML

How can a CML be handled?

For the treatment of CML, various options are available, some of which are also used in combination. These are on the one hand medication and on the other hand in special cases the stem cell transplantation [2].

Medication such as tyrosine kinase inhibitors or interferons can prevent worsening of the disease. In certain situations, chemotherapy is also used. The primary goal of drug treatment is to prevent progression of the disease. The patient should be kept stable in the chronic phase. The doctor will work together with you therefore select the therapy so that the leukemia cells are permanently suppressed by the treatment and as soon as an improvement in the blood picture is achieved. [2]

If the drug therapy does not work or in certain cases a stem cell transplantation can be considered. In a stem cell transplant, the degenerate stem cells in the patient's bone marrow are first destroyed and then replaced with new, healthy stem cells from a donor. This form of treatment can bring healing to the patient but is associated with high risks. [7]

For you to read on:

    Therapy goal in CML: stop, push back, stabilize
    Treatment with CML - an overview
    Current therapy recommendations for CML
    Therapy with tyrosine kinase inhibitors

What are the prospects?

Modern therapies have transformed CML from an immediate life-threatening to a chronic disease. CML is easily controllable in many cases, and patients often have an almost normal life over many years. [6]

In order to achieve the best possible outcome of treatment, it is important to have regular follow-up examinations. As a result, changes in the course of therapy can be detected early. The doctor can then initiate appropriate countermeasures. It is currently being examined in clinical trials whether, in favorable cases, a stable decline in disease can be achieved, possibly allowing discontinuation of therapy [2].

For you to read on:

    A positive view of the CML therapy
    Therapy yesterday and today
    CML on the way to freedom of therapy?

Where can I get more information?

Further information about CML can be found here:

    Initiative Life with CML
    CML hotline
    CML film for patients, relatives and interested people
    information material
    Links & self-help

Clarify any open questions with your doctor

All this information can help you, but do not replace a detailed conversation with your attending physician. Together with him you will plan your therapy and he will be your contact person in all phases of your illness.

At the time of diagnosis you are sure to have a lot of questions. It is very important to clarify this, so that you can deal with your illness and remove as much as possible of all uncertainties. Our checklist is intended to give you some clues to talk to your doctor