- Chronic myeloid leukaemia (CML) starts when the bone marrow produces partly-mature white blood cells that grow and spread abnormally
- The white blood cells that CML affect are called granulocytes. They are a type of myeloid blood cell that moves through a large network of tissues and organs called the lymphatic system and impact areas such as the lymph nodes, spleen and liver. When bone marrow produces too many granulocytes, they are called blasts or leukaemic blasts
- Chronic leukaemia develops slowly and may take months or years for symptoms to develop
- Overall, leukaemia accounts for 7% of all cancer cases in Malaysia. CML is an uncommon type of leukaemia that mainly affects adults
Home
Chronic Myeloid Leukaemia
Chronic Myeloid Leukaemia
Chronic myeloid leukaemia is a type of blood cancer which develops when the body has too many abnormal white blood cells, known as granulocytes.
Last modified: February 25, 2022
The type of CML you have is defined by your cell blood cell count, differential (the number of different types of white blood cells in your blood) and the presence of genetic abnormalities. This includes the identification of the Philadelphia chromosome and BCR-ABL gene.
- Philadelphia chromosome – Your cells contain 23 chromosomes. The Philadelphia chromosome develops in chromosome 22 when part of chromosome 9 joins onto it. This new type of chromosome contains the BCR-ABL gene that tells leukaemia cells to grow and spread
As signs and symptoms for CML can be similar to other common conditions, it’s important to see your GP or healthcare professional if you experience any of the symptoms below. Discussing anything concerning with your doctor as soon as possible can help give you peace of mind and offer the best chance of successful treatment if you receive a CML diagnosis.
Although CML has no symptoms in many cases and is often diagnosed during routine blood tests, symptoms may include:
-
Tiredness
-
Anaemia, including dizziness, paleness and shortness of breath
-
Night sweats
-
High temperature
-
Unexplained weight loss and loss of appetite
-
Bone pain
-
Swollen, painless lymph nodes under the arms, neck or groin
-
Enlarged abdomen and feeling full after eating a small amount
-
Increased bleeding and bruising
Unlike other cancers, CML is classified into phases rather than stages. These phases are based on the number of immature white blood cells in your bone marrow and blood.
Chronic phase
This phase can last many years and is when most people are diagnosed. The blast cell numbers in the blood and bone marrow are low (< 5%), which means the phase is relatively stable. There are few (if any) symptoms in this stage.
Accelerated phase
During the accelerated phase, the number of blast cells start to increase in the bone marrow and blood.
Blast phase
The blast phase is a period of rapid progression where blast cell numbers in the blood and bone marrow increase quickly. In the blast phase, symptoms worsen and CML can become similar to acute leukaemia.
Is chronic myeloid leukaemia hereditary?
CML is not hereditary. Although genetic abnormalities can cause CML, these are not passed down from parents and instead occur during your lifetime.
What causes chronic myeloid leukaemia?
The causes of CML are not fully known. However, there are some factors which contribute to the risk of CML developing, including:
- Age – Nearly 70% of all cases of CML are diagnosed in adults over the age of 40
- Gender –Men are more likely to develop CML than women
- Genetic abnormalities – Nearly all people with CML have a genetic abnormality known as the Philadelphia chromosome. It contains the BCR-ABL gene that tells leukaemia cells to grow and spread. The Philadelphia chromosome is not inherited and cannot be passed down
- Exposure to radiation and certain chemicals – Exposure to high doses of radiation and benzene, as well as some chemotherapy treatments increase your risk of developing CML
How common is chronic myeloid leukaemia?
Overall, leukaemia accounts for 3.7% of all cancer cases in Malaysia. CML is an uncommon type of leukaemia that mainly affects adults.
How is chronic lymphocytic myeloid diagnosed?
There are many different tests that are used to diagnose CML, alongside a physical examination. This may include blood tests and a bone marrow biopsy to check your full blood count and see if you have the Philadelphia chromosome. You may also receive an ultrasound to identify if your spleen has been affected.
What is the difference between chronic myeloid leukaemia (CML) and chronic lymphocytic leukaemia (CLL)?
CML and CLL are two forms of chronic leukaemia which develop from different types of white blood cells. CML develops from myeloid cells called granulocytes, while CLL develops from lymphocytes such as B-cells and T-cells.
What can I do to decrease my risk of chronic myeloid leukaemia?
There are no known ways to prevent CML. However, there are a number of lifestyle-related factors you can consider to reduce your risk of developing cancer overall, like:
- Avoiding high doses of radiation and certain chemicals
- Getting regular exercise – At least 30 minutes of moderate-intensity exercise each day
- Eating a healthy, balanced diet – Eat a fibre-rich diet from grain and legume sources, as well as enjoy a variety of fruit (2 serves) and vegetables (5 serves) per day, limit your intake of salt, saturated fats, and avoid all processed meat
Helpful Links
ReferencesReferences
For a full list of references, click here.
- Institute Kanser Negara. (2023). Summary of Malaysian National Cancer Registry Report 2012-2016. Retrieved on 4 October 2023 from https://nci.moh.gov.my/index.php/ms/pengumuman/789-summary-of-malaysian-national-cancer-registry-report-2012-2016
- World Health Organisation, The Global Cancer Observatory 2020. Retrieved on 3 November 2023 https://gco.iarc.fr/today/data/factsheets/populations/458-malaysia-fact-sheets.pdf
- MyHEALTH Kementerian Kesihatan Malaysia. Retrieved on 10 November 2023. http://www.myhealth.gov.my/en/leukemia-2/
- Leukaemia Foundation. (2020). Chronic myeloid leukaemia (CML). Retrieved 12 January 2022 from https://www.leukaemia.org.au/blood-cancer-information/types-of-blood-cancer/leukaemia/chronic-myeloid-leukaemia/
- Cancer Council. (2020). Chronic myeloid leukaemia (CML). Retrieved 12 January 2022 from https://www.cancercouncil.com.au/chronic-myeloid-leukaemia/#Who-gets-CML
- American Cancer Society. (2018). Chronic Myeloid Leukemia (CML). Retrieved 12 January 2022 from https://www.cancer.org/cancer/chronic-myeloid-leukemia.html
- Macmillan Cancer Support. (2020). Chronic myeloid leukaemia (CML).. Retrieved 12 January 2022 from https://www.macmillan.org.uk/cancer-information-and-support/leukaemia/chronic-myeloid-leukaemia-cml
- Mayo Clinic. (2021). Chronic myelogenous leukemia. Retrieved 12 January 2022 from https://www.mayoclinic.org/diseases-conditions/chronic-myelogenous-leukemia/symptoms-causes/syc-20352417
- Arber, D. A., Orazi, A., Hasserjian, R., Thiele, J., Borowitz, M. J., Le Beau, M. M., Bloomfield, C. D., Cazzola, M. and Vardiman, J. W. (2016). The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood, 127(20): 2391–2405. 1182/blood-2016-03-643544
- Hochhaus A, Saussele S, Rosti G, Mahon FX, Janssen JJWM, Hjorth-Hansen H, Richter J, Buske C; ESMO Guidelines Committee. (2017). Chronic myeloid leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 28 (Supplement 4): iv41–iv51, doi:10.1093/annonc/mdx219
More information
Make An Appointment
We are here to help you navigate this difficult time and to focus on the individual needs of our patients and their families offering both in-person and telemedicine consultations.
Cancer Information Library
A library of articles and resources developed by Icon to help you gain a better understanding of a cancer diagnosis and treatments.
Our doctors
Icon brings together some of Malaysia’s most experienced clinical oncologists, medical oncologists and radiation oncologists.
Families and carers
Helpful information on finding the right support when caring for a loved one with cancer.