Chronic myelogenous leukemia (CML)

Table of Contents

Alternative Names

CML; Chronic granulocytic leukemia; Leukemia - chronic granulocytic (CML)


Symptoms

CML causes rapid growth of the immature blood-forming cells (myeloid precursors) in the bone marrow, blood, and body tissues.

Chronic myelogenous leukemia is grouped into several phases:

  • Chronic
  • Accelerated
  • Blast crisis

The chronic phase can last for months or years. The disease may have few or no symptoms during this time. Most people are diagnosed during this stage, when they are having blood tests done for other reasons.

The accelerated phase is a more dangerous phase, during which the leukemia cells grow more quickly. This phase may be associated with fever (without infection), bone pain, and a swollen spleen.

If untreated, CML progresses to the blast crisis phase. Bleeding and infection may occur due to bone marrow failure. Other possible symptoms include:

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

Signs and tests

A physical examination often reveals a swollen spleen. A complete blood count (CBC) shows an increased number of white blood cells.

Other tests that may be done include:

  • Bone marrow aspiration and biopsy
  • CBC with white blood cell differential
  • Blood and bone marrow testing for the presence of the Philadelphia chromosome

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

  • Platelet count
  • Uric acid


Review Date: 03/02/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)