Chronic myelogenous leukemia (CML)

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Chronic myelogenous leukemia (CML)

Chronic myelogenous leukemia is characterized by a chronic phase that can last for months or years. The disease may have few or no symptoms during the chronic phase. Eventually, the chronic phase progresses to a more dangerous "accelerated phase," during which the leukemia cells grow more quickly.

Acceleration of the disease may be associated with fever (without infection), bone pain, and an enlarged spleen. Within 5 years, in most people, the disease then progresses to a "blast crisis," when there is a very high count of immature white blood cells (leukemia cells). The blast phase of the leukemia is very difficult to treat. Bleeding and infection may occur due to bone marrow failure.

Other possible symptoms include:

• Fatigue
• Weakness
• Excessive sweating (night sweats)
• Low-grade fever
• Pressure under the left ribs from an enlarged spleen
• Bleeding and bruising
• Sudden appearance of small red marks on the skin (petechiae)

• A physical examination often reveals an enlarged spleen
• A CBC shows increased white blood cell count
• A CBC differential is consistent with increased numbers of white blood cells, either mature or immature (depending on whether the disease is in the chronic or blast phase)

Additional signs and tests include:

• Bone marrow aspiration
• The presence of the Philadelphia chromosome
• The leukocyte alkaline phosphatase level

This disease may also alter the results of the following tests:

• Vitamin B-12 level
• Uric acid
• Platelet count

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