• Chronic Myelogenous Leukemia (CML) Overview

    Chronic myelogenous leukemia, also called chronic myeloid leukemia or CML, is a slowly progressing type of blood cancer that develops in the bone marrow, the soft, spongy center of long bones. Bone marrow produces the three major types of blood cells.

    In CML, the infection-fighting white blood cells (WBC) affected are a specific kind of cell called myeloblasts. When these cells are healthy, they only reproduce when there is enough space for them to fit. The body regulates this by sending signals, telling the cells when to stop reproducing. With CML, the bone marrow makes abnormal WBC that don’t respond to these signals and keep reproducing regardless of space. These abnormal WBC reproduce quickly and, unlike healthy cells, don’t fight off infection.

    CML Treatment at Dana-Farber/Boston Children's

    Patients with CML are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through the Leukemia Program. Continue reading to learn more about CML or visit the Leukemia Program homepage to learn about our expertise and treatment options for this condition.

    Symptoms & Diagnosis

    Symptoms arise when abnormal cells, called “blasts,” crowd out healthy cells. In the early stages of CML, there usually aren’t symptoms. When they do occur, a child may experience them over a period of months or even years.

    The most common symptoms of CML include:

    • Fatigue
    • General weakness
    • Recurrent infections
    • Bone and joint pain from overcrowded bone marrow
    • Abdominal pain due to enlargement of the spleen, kidney or heart from the collection of leukemia cells
    • Swollen lymph nodes in the groin, chest or neck

    CML is often diagnosed during a routine blood test conducted for other reasons. Other diagnostic tests include:

    • Bone marrow aspiration and biopsy
    • Lymph node biopsy
    • Complete blood count
    • Blood chemistry tests
    • Liver and kidney function tests

    After all tests are completed, doctors will be able to outline the best treatment options.

    Treatment & Care Options

    Treatment options for CML may include (alone or in combination):

    • Chemotherapy 
    • Stem cell transplantation 
    • Tyrosine-Kinase Inhibitor (TKI)
    • Biologic therapies that use the body’s immune system to fight the cancer
    • Blood transfusions
    • Antibiotics to prevent and treat infections

    Progressive or Recurrent Disease

    If CML recurs, the treatment plan often includes targeted therapy (chemotherapy drugs that specifically attack a molecular pathway required to keep a tumor growing), chemotherapy and immunotherapy (treatment that stimulates the immune system to reject and destroy a tumor).

    Long-term Outlook

    Relapse of CML can occur at any stage of treatment, even with aggressive therapy or after treatment has ended. Prognosis and long-term survival for recurrent CML vary. Prompt medical attention and aggressive therapy are important for the best outcomes.
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  • Stem Cell Transplant

    Dana-Farber/Boston Children's has one of the largest and most experienced pediatric stem cell transplant programs in the United States. Watch Dr. Leslie Lehmann explain how stem cell transplants work.