Chronic Myeloid Leukemia (CML) Treatment | I D Cancer Center
Advanced Diagnosis & Modern Targeted Therapy at I D Cancer Center, Lucknow
Chronic Myeloid Leukemia (CML) is a type of blood cancer that begins in the bone marrow and causes uncontrolled growth of abnormal white blood cells. It usually develops slowly and is most common in adults, but can occur at any age.
The remarkable progress in targeted therapies has transformed CML into a highly manageable and often long-term controllable condition.
What Is Chronic Myeloid Leukemia?
CML occurs due to a genetic change in bone marrow cells known as the Philadelphia chromosome, which creates an abnormal BCR-ABL gene. This gene signals the body to produce too many white blood cells.
CML typically progresses through three phases:
Chronic phase – slow progression, most patients diagnosed here
Accelerated phase – faster disease progression
Blast crisis – aggressive phase resembling acute leukemia
Early diagnosis and treatment help prevent progression.
CML occurs due to a genetic change in bone marrow cells known as the Philadelphia chromosome, which creates an abnormal BCR-ABL gene. This gene signals the body to produce too many white blood cells.
CML typically progresses through three phases:
Chronic phase – slow progression, most patients diagnosed here
Accelerated phase – faster disease progression
Blast crisis – aggressive phase resembling acute leukemia
Early diagnosis and treatment help prevent progression.
Common Symptoms of CML
Many people have no symptoms in early stages. When present, symptoms may include:
Fatigue
Unexplained weight loss
Early fullness after meals
Night sweats
Persistent fever
Enlarged spleen causing abdominal discomfort
Bone pain
Frequent infections
Easy bruising or bleeding
Routine blood tests often detect CML before symptoms appear.
Many people have no symptoms in early stages. When present, symptoms may include:
Fatigue
Unexplained weight loss
Early fullness after meals
Night sweats
Persistent fever
Enlarged spleen causing abdominal discomfort
Bone pain
Frequent infections
Easy bruising or bleeding
Routine blood tests often detect CML before symptoms appear.
Risk Factors
Age: more common in adults
Male gender (slightly higher risk)
Exposure to high-dose radiation
Genetic changes (e.g., Philadelphia chromosome)
CML is not inherited and does not run in families.
Age: more common in adults
Male gender (slightly higher risk)
Exposure to high-dose radiation
Genetic changes (e.g., Philadelphia chromosome)
CML is not inherited and does not run in families.
How CML Is Diagnosed
At I D Cancer Center, diagnosis involves:
At I D Cancer Center, diagnosis involves:
1. Complete Blood Count (CBC)
High white blood cell count
Abnormal cell types
High white blood cell count
Abnormal cell types
2. Bone Marrow Examination
Confirms leukemia
Checks disease phase
Confirms leukemia
Checks disease phase
3. Genetic Tests
To identify the Philadelphia chromosome (BCR-ABL):
FISH test
PCR test
Cytogenetic analysis
These guide treatment and help track response.
To identify the Philadelphia chromosome (BCR-ABL):
FISH test
PCR test
Cytogenetic analysis
These guide treatment and help track response.
4. Additional Tests
Liver/kidney function
Spleen size assessment
Monitoring of response to treatment over time
Liver/kidney function
Spleen size assessment
Monitoring of response to treatment over time
Treatment Options at I D Cancer Center
1. Targeted Therapy (TKIs) — Mainstay Treatment
These medicines block the BCR-ABL protein:
Imatinib
Dasatinib
Nilotinib
Bosutinib
Ponatinib (for resistant cases)
With TKIs, most patients achieve excellent control and live near-normal lives.
These medicines block the BCR-ABL protein:
Imatinib
Dasatinib
Nilotinib
Bosutinib
Ponatinib (for resistant cases)
With TKIs, most patients achieve excellent control and live near-normal lives.
2. Chemotherapy
Used rarely, mainly in accelerated or blast crisis phases.
Used rarely, mainly in accelerated or blast crisis phases.
3. Stem Cell / Bone Marrow Transplant
Considered when:
Disease is resistant to TKIs
Blast crisis occurs
High-risk genetic features are present
We coordinate with specialized transplant centers for seamless care.
Considered when:
Disease is resistant to TKIs
Blast crisis occurs
High-risk genetic features are present
We coordinate with specialized transplant centers for seamless care.
4. Radiation Therapy
Used selectively for:
Spleen enlargement causing symptoms
Bone pain
Localised disease control
Used selectively for:
Spleen enlargement causing symptoms
Bone pain
Localised disease control
5. Supportive Care
Anemia management
Infection prevention
Counseling & lifestyle guidance
Anemia management
Infection prevention
Counseling & lifestyle guidance
Monitoring Treatment Response
Regular monitoring is essential:
PCR testing at intervals (3, 6, 12 months)
Checking for molecular response
Ensuring BCR-ABL levels continue to fall
Good adherence to medication leads to long-term remission.
Regular monitoring is essential:
PCR testing at intervals (3, 6, 12 months)
Checking for molecular response
Ensuring BCR-ABL levels continue to fall
Good adherence to medication leads to long-term remission.
Prognosis
With modern TKIs, CML has an excellent long-term prognosis. Many patients:
Achieve deep molecular remission
Live normal lifespans
Can maintain routine work and lifestyle
May even discontinue medication under strict guidelines (treatment-free remission)
With modern TKIs, CML has an excellent long-term prognosis. Many patients:
Achieve deep molecular remission
Live normal lifespans
Can maintain routine work and lifestyle
May even discontinue medication under strict guidelines (treatment-free remission)
