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Overview
What is Chronic Myeloid Leukaemia (CML)?
- CML is a type of blood cancer that starts in the bone marrow, where blood cells are made.
- It affects the white blood cells, causing them to grow uncontrollably.
- CML is called “chronic” because it often develops slowly compared to other types of leukaemia.
Who is affected?
- CML can affect both adults and children, but it is most commonly diagnosed in adults over the age of 40.
- It is slightly more common in men than in women.
Causes and Risk Factors
Why does it happen?
- CML is usually caused by a change (mutation) in the DNA of blood-forming cells, specifically a piece of chromosome 9 and 22 swapping places, creating the “Philadelphia chromosome.”
- This change is not inherited; it happens by chance.
Are certain people more at risk?
- The main risk factor is age (older adults are more commonly affected).
- Exposure to high doses of radiation (rare).
- Most people with CML have no clear risk factors.
Symptoms
What are the common signs and symptoms?
- Many people have no symptoms at first and are diagnosed after a routine blood test.
- When symptoms appear, they may include:
- Tiredness or fatigue
- Unexplained weight loss
- Night sweats
- Fever
- Fullness or discomfort in the left upper abdomen (from an enlarged spleen)
- Easy bruising or bleeding
- Frequent infections
Diagnosis
How is it diagnosed?
- CML is often suspected from a routine blood test showing high white blood cell counts.
What tests are commonly done?
- Blood tests: To check white cell counts and look for abnormal cells.
- Bone marrow test: A sample is taken to look for leukaemia cells.
- Genetic (molecular) testing: Looks for the Philadelphia chromosome or BCR-ABL gene.
Treatment Options
What are the treatment choices?
- Targeted therapy: The main treatment is with tablets called tyrosine kinase inhibitors (TKIs), such as imatinib, dasatinib, nilotinib, ponatinib and asciminib.
- Other options: In rare cases, chemotherapy, interferon, or a stem cell (bone marrow) transplant may be considered.
- Advanced or investigational therapies: New TKIs or clinical trials may be offered if the first treatment isn’t effective.
Dietary Advice
Specific dietary recommendations:
- Eat a balanced diet with plenty of fruits, vegetables, whole grains, and lean proteins.
- Wash fruits and vegetables well to reduce infection risk.
Nutrition tips to support treatment or symptom control:
- Stay hydrated, especially if taking medicines that may affect the kidneys.
- If you have a poor appetite or lose weight, try small, frequent meals.
- Tell your doctor if you have difficulty eating or swallowing.
Common supplements (if applicable) and when to discuss with your doctor:
- Ask your doctor before starting any vitamins or supplements, especially if you’re taking TKIs, as some may interact.
Address food safety or drug-food interactions if relevant:
- Grapefruit and some citrus fruits can interact with TKIs—avoid these unless your doctor says it’s safe.
- Practice good food hygiene to reduce infection risk.
Living with the Condition
Managing daily activities:
- Most people can continue normal daily routines during treatment, though you may feel more tired.
Exercise, lifestyle, and emotional well-being:
- Light to moderate exercise (like walking) can help with energy and mood—check with your doctor first.
- Take time to rest and listen to your body.
- Seek support from family, friends, or a counselor if you feel anxious or depressed.
Tips for long-term monitoring and follow-up:
- Regular blood tests are essential to monitor your response to treatment.
- Attend all scheduled appointments and tell your doctor about any side effects.
- Keep a list of your medicines and share it with any healthcare provider you see.
FAQs
1. Is CML curable?
- CML is usually a long-term, manageable condition. Many people live normal lives with ongoing treatment. In some cases, patients may be able to stop their medication but only under medical supervision, and this needs to be monitored. In less common situations, a bone marrow transplant may be needed in ordert to cure CML.
2. Will I need to stay in the hospital?
- Most treatment is taken at home as tablets. Hospital stays are uncommon unless complications arise.
3. Can I work or go to school?
- Many people can continue working or studying during treatment but may need to adjust their schedule if they feel tired.
4. Are there any side effects from treatment?
- Common side effects include tiredness, nausea, muscle aches, or skin rashes. Tell your doctor about any side effects—you may need a dose adjustment or additional support.
5. Should I tell my family and friends?
- It can help to share your diagnosis with people you trust. Support from others is important during treatment.
Call to Action: When to Contact a Doctor
- If you have a fever, unusual bleeding, severe tiredness, difficulty breathing, or any new or worsening symptoms, contact your healthcare team right away.
Other Information Resources
Local support: Max Family Malaysia
This information is provided for educational purposes and does not replace medical advice. Always consult your doctor or healthcare team for advice specific to your situation.