What are the causes, risk factors, and treatment options for chronic myeloid leukemia?

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BEST BMT Dr.Pawan Kumar Singh
Dr Pawan Kumar Singh
Dr Pawan Kumar Singh has the experience of
performing more than 500 bone marrow transplants
(including Autologous /Allogenic /Haplo /MDU )for
both malignant and non-malignant disorders.
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Content
Topic for Discussion
Chronic Myeloid Leukemia
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Stages OF CML
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Risk Factors Of CML
03
Treatment options for CML
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INTRODUCTION
Chronic Myeloid Leukemia (CML) primarily affects
adults and is rare in children. It involves the
excessive proliferation of immature white blood
cells, or granulocytes, within the bone marrow.
These immature cells proliferate in the bone
marrow and bloodstream, disrupting the production
of other blood components such as red blood
cells, white blood cells, and platelets.
Fortunately, with advanced treatment options, CML
is now manageable, offering favorable prognoses.
It's important to note that CML is not
genetically inherited from parents. Seeking
expertise from hematologist specialists in Delhi
ensures comprehensive and effective management of
CML.
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Stages OF Chronic Myeloid Leukemia
Chronic Phase

• Chronic Phase This initial stage of CML
  typically manifests with minimal or no noticeable
  symptoms. At this juncture, only a small
  percentage (around 10) of blast cells are
  detected in the bone marrow.

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Accelerated Phase
Accelerated Phase As the disease progresses, the
number of myeloblasts increases to approximately
20 and additional abnormalities may emerge.
Symptoms begin to surface during this phase,
signaling the progression of the disease.
Blastic Phase
Blastic Phase In the advanced stage of CML,
myeloblasts outnumber normal blood cells (RBCs,
WBCs, and platelets), exceeding the 20
threshold. Symptoms become more pronounced and
severe, including spleen enlargement,
susceptibility to severe infections, bleeding
tendencies, and significant weight loss
accompanied by weakness.
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Risk Factors Of Chronic Myelogenous Leukemia
1 Genetic Abnormalities Specific genetic
mutations, notably the Philadelphia chromosome
resulting from chromosomal translocation,
heighten the susceptibility to CML.
2 Radiation Exposure Prolonged exposure to
ionizing radiation, prevalent in radiation
therapy or nuclear accidents, elevates the risk
of CML development.
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3 Age While CML may manifest at any age, it
predominantly affects adults, with the likelihood
increasing, notably after 60 years.
4 Gender Disparity Men exhibit a marginally
higher predisposition to CML compared to women.
5 Family History While CML isn't typically
hereditary, individuals with a familial history
of CML or other blood cancers may face an
escalated risk.
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Chronic Myeloid Leukemia Causes
1 Radiation Exposure Common among atomic bomb
survivors or those heavily exposed to radiation,
CML can develop in patients treated with high
radiation doses for other cancers. Notably,
exposure from routine dental and full-body scans
is generally safe and does not contribute to CML.
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Chronic Myeloid Leukemia Causes
2 Mutation in Stem Cells A pivotal cause
involves the exchange between chromosomes 9 and
22, leading to the creation of the Philadelphia
chromosome. This genetic abnormality is prevalent
in CML patients and originates in abnormal blood
cells' stem cells.
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Treatment options for Chronic Myeloid Leukemia

• Tyrosine Kinase Inhibitors (TKIs) Representing
  the frontline treatment, TKIs like imatinib,
  dasatinib, and nilotinib target the BCR-ABL
  protein generated by the Philadelphia chromosome.
  These drugs effectively control CML progression
  and are typically the initial therapeutic choice.

• Clinical Trials Participation in clinical trials
  presents an opportunity for patients,
  particularly those with refractory or advanced
  CML, to explore novel therapies and treatment
  modalities. These trials assess experimental
  approaches aimed at enhancing treatment outcomes
  and elevating the quality of life for individuals
  grappling with CML.

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• Chemotherapy Although less commonly utilized
  than TKIs, chemotherapy may be employed in
  specific scenarios, particularly in advanced CML
  or when alternative treatment options are
  exhausted. Chemotherapeutic agents target rapidly
  dividing cells, including cancerous cells, to
  impede disease progression.

• Supportive Care Beyond active treatments,
  hematologist specialists in Delhi prioritize
  supportive care to alleviate symptoms, forestall
  complications, and bolster overall well-being.
  Supportive measures may encompass blood
  transfusions, prophylactic antibiotics to combat
  infections, and medications to mitigate
  treatment-related side effects.

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