HJNO Sep/Oct 2023

54 SEP / OCT 2023 I  HEALTHCARE JOURNAL OF NEW ORLEANS ONCOLOGY DIAL GUE COLUMN ONCOLOGY Introduction Chronic myeloid leukemia (CML) is a chronic, long-term, slowly developing form of leukemia. People with CML have an in- crease in the number of immature (young) white blood cells in their blood, bone marrow, and spleen. Some people have no symptoms when they are diagnosed with CML, and it is discovered when blood tests are done for another reason. Abnormalities in blood tests include in- creased platelets, anemia, and a high white blood cell count. Other people have symp- toms such as enlargement of the spleen, fa- tigue, bone pain, fevers, night sweats, and/ or weight loss. Symptoms of CML typically develop gradually. In a small percentage of people, CML transforms into an aggressive form of acute leukemia with more severe symptoms and increasingly abnormal white blood cells (called leukemic blast cells). CML occurs when a cell in the bone mar- row undergoes a breakage of two chro- mosomes (chromosomes 9 and 22), which then fuse to form a characteristic abnor- mal chromosome, called the Philadelphia chromosome. The chromosome fusion causes an exchange of genetic information in which two separate genes, BCR andABL1, are joined together. The resultant abnormal gene, BCR::ABL1, causes bone marrow cells to produce an abnormal protein (the BCR::ABL1 tyrosine kinase), which stimulates CML cells to grow and survive better than normal blood cells. People with CML develop the chromo- some/gene abnormality during their lifetime; that is, it is not something that you are born with or pass on to your children. Its cause is unknown. Symptoms CML does not always cause symptoms, es- pecially at first. When it does cause symp- toms, the most common ones are: 1. Feeling very tired and weak. 2. Sweating much more than usual. 3. Losing weight without trying. 4. Feeling full after eating a small amount of food. 5. Bleeding more easily than normal. Diagnosis CML is diagnosed with blood work, includ- ing a peripheral smear review of your blood to look for the morphology of CML. Also, with blood work or a bone marrow biopsy, we can send chromosomal analysis and cytogenet- ics to confirm the Philadelphia chromosome or translocation (9;22). A positive result of this will confirm the diagnosis of CML. To CHRONIC MYELOID LEUKEMIA 2023