Chronic Myeloid Leukemia Facts

Chronic myelogenous leukemia (CML) or chronic granulocytic leukemia is a slow progressing blood disease that rarely occurs in children. About two to three percent of children with leukemia have CML.

 

In CML, too many blood stem cells develop into a type of white blood cell called granulocytes, which do not become healthy white blood cells. These cells can build up in the blood and bone marrow so there is less room for healthy white blood cells, red blood cells, and platelets. When this happens, infection, anemia, or easy bleeding may occur.

Symptoms

Symptoms include night sweats, fever, tiredness, but sometimes, there are no symptoms at all.

 

Diagnosis

To find out whether your child has CML, your child’s doctor will first do a thorough physical exam and ask about your child’s health history. Next the doctor will probably perform a series of blood tests to tell whether any blood cells are unhealthy and, if so, which type. Common blood tests to check for leukemia include the following:

• Complete blood count, or CBC: to determine how many cells of each type are circulating in the blood stream
• Peripheral blood smear: to look at the appearance of the blood cells
• Blood chemistry: to look for chemicals in the blood that can be abnormal in people who have cancer

For a clear diagnosis, doctors may need to perform a bone marrow aspirate and sometimes a bone marrow biopsy. A small area of skin over the pelvis (the bone that makes up part of the hip) will be cleaned and numbed. Then a teaspoon of bone marrow will be withdrawn with a needle (aspirate). Your child will receive medicines to help with any pain or discomfort associated with this procedure.

 

More specific laboratory tests of the blood can give your child’s doctors more information about the type of cells affected. These include tests that identify proteins on the surface of the leukemic cells and tests that look at the arrangement of chromosomes in the leukemic cells.

Doctors may do further tests to detect whether the cancer has spread to parts of your child’s body beyond the blood. For instance, a lumbar puncture, or spinal tap, may be done to remove cerebrospinal fluid (CSF) from the spinal column using a needle. If there are leukemic cells in the CSF, doctors know the brain and spinal cord may be affected by the cancer. A chest X-ray can provide a view into the chest area. A biopsy of the testicles, ovaries or skin helps doctors determine whether the cancer has spread there.

Based on what they learn through their diagnostic tests, doctors may classify your child’s leukemia into a category. The categories are designed to help doctors select the most appropriate treatment for each child.

 

Phases

CML has three phases:

1. Chronic phase -fewer than 10 percent of the cells in the blood and bone marrow are blast cells (immature cells).
2. Accelerated phase - 10 to 19 percent of the cells in the blood and bone marrow are blast cells.
3. Blastic phase - 20 percent or more of the cells in the blood or bone marrow are blast cells.