Chronic Myeloid Leukaemia (CML)

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This blog is for informational purposes only and should not be taken as medical advice. Content is sourced from third parties, and we do not guarantee accuracy or accept any liability for its use. Always consult a qualified healthcare professional for medical guidance.

What is Chronic Myeloid Leukaemia (CML)?

Chronic Myeloid Leukaemia (CML) is a slow-growing blood cancer caused by the Philadelphia chromosome t(9;22), creating BCR-ABL fusion gene leading to uncontrolled myeloid cell production. Phases include chronic (80-90% diagnosed here), accelerated, and blast crisis (acute leukaemia-like). In 2025, ~9,000 US cases annually, median age 64, more in men.

Symptoms

Chronic phase is often asymptomatic or mild: fatigue, weight loss, night sweats, abdominal fullness (splenomegaly), easy bruising, fever. Accelerated/blast phases cause severe symptoms like bleeding, infections, bone pain, and anemia. Symptoms progress over years if untreated.

Causes

The BCR-ABL translocation is the hallmark, with no clear cause but risk from high-dose radiation. Age, male gender, and obesity increase risk. In 2025, research shows microenvironment and additional mutations drive progression.

Diagnosis

Diagnosis uses CBC showing high white cells (basophils, eosinophils), peripheral smear with myelocytes, and bone marrow biopsy. FISH/PCR confirms BCR-ABL. Cytogenetics assesses Philadelphia chromosome. In 2025, NGS detects resistance mutations.

Treatment

Tyrosine kinase inhibitors (TKIs: imatinib, dasatinib, nilotinib, bosutinib, ponatinib) are first-line, achieving 90% 10-year survival. SCT for resistant cases. In 2025, asciminib (ABL myristoyl pocket inhibitor) treats resistant CML.

Future Outlook

In 2025, 10-year survival is 90% with TKIs, with many achieving treatment-free remission. Research on TKI discontinuation and novel inhibitors could make CML curable by 2030, with 95% survival.

Sources

The information for CML is drawn from Wiley’s “Chronic myeloid leukemia: 2025 update on diagnosis, therapy, and monitoring” for 2025 updates; Cleveland Clinic’s “Chronic Myeloid Leukemia (CML): Symptoms, Treatment & Prognosis” for symptoms and treatment; PubMed’s “Chronic myeloid leukemia: 2025 update” for diagnosis; MD Anderson’s “Chronic Myeloid Leukemia (CML)” for overview; Cancer Research UK’s “Daily life, support and chronic myeloid leukaemia (CML)” for living with CML; Nature’s “2025 European LeukemiaNet recommendations” for guidelines; Cincinnati Children’s “Chronic Myeloid Leukemia | Symptoms, Diagnosis & Treatment” for pediatric insights; Healthline’s “Everything You Want to Know About Chronic Myeloid Leukemia” for outlook; Stanford Health Care’s “Chronic Myeloid Leukemia (CML)” for care; Everyday Health’s “Understanding Chronic Myeloid Leukemia: Causes, Symptoms, and Treatment” for causes.