Although it is uncommon in children under the age of 10, chronic myelocytic leukemia (CML) is a kind of blood cancer that can affect people of any age and gender. CML typically appears in individuals between the ages of 40 and 60. The Philadelphia chromosome, a genetic rearrangement, is the main contributor to CML. Tyrosine kinase, an unusual enzyme produced as a result of this defective chromosome, causes aberrant white blood cell development.

Most leukemia cells in CML are formed in the bone marrow, although some are also made in the spleen and liver. The chronic stage of CML is characterized by considerable increases in the number of normal-appearing white blood cells and rarely platelets, in contrast to acute leukemias, when a significant number of immature white blood cells are present. More leukemia cells accumulate in the bone marrow as the illness worsens, while others enter the bloodstream.

Over time, the leukemia cells undergo further changes, advancing the disease to an accelerated phase and eventually to a blast crisis. In the blast crisis stage, the spleen often enlarges significantly, accompanied by symptoms like fever and weight loss. In the early chronic stage of CML, individuals may not experience noticeable symptoms. However, some may develop fatigue, weakness, loss of appetite, weight loss, fever, night sweats, and a feeling of fullness, usually caused by an enlarged spleen. As the disease progresses to blast crisis, individuals become sicker due to a decrease in the number of red blood cells and platelets, resulting in paleness, bruising, and bleeding.

A simple blood test is typically the initial step in diagnosing CML. The test may reveal an abnormally high white blood cell count. Microscopic examination of blood samples may also show the presence of less mature white blood cells, which are usually confined to the bone marrow. Additional tests, such as cytogenetics or molecular genetics, are necessary to confirm the diagnosis by detecting the Philadelphia chromosome.

Treatment options for CML aim to slow down the progression of the disease, as a complete cure is rare. Newer drugs have been developed to target and inhibit the abnormal enzyme produced by the Philadelphia chromosome. These medications are more effective and generally have minimal side effects.

The 5-year survival rate for CML is over 90% from the time of diagnosis. Stem cell transplantation, combined with high doses of chemotherapy drugs, can potentially cure CML. However, transplantation is only suitable for certain individuals and requires a compatible tissue type donor, often a sibling. Transplantation is most successful in the early stages of the disease and becomes less effective as CML rapidly progresses or enters the blast crisis phase.

Without treatment, individuals in blast crisis typically survive only a few months. However, chemotherapy drugs can extend survival to 12 months or longer. In cases of CML without the Philadelphia chromosome, older chemotherapy regimens may be administered to alleviate symptoms, but they do not prolong survival.

Conclusion

 Blood malignancy known as Chronic myelocytic leukemia mainly affects people between the ages of 40 and 60. The Philadelphia chromosome, which causes the disease by causing an aberrant enzyme to be produced, causes white blood cells to develop abnormally. Early-stage CML patients might not experience any symptoms, but as the condition worsens, people might start to feel tired, lose weight, have a fever, and develop an enlarged spleen. Blood testing and additional chromosomal analysis are frequently used to confirm diagnoses. Although CML cannot be completely cured, therapy methods include stem cell transplantation and targeted medications can delay the disease's progression and increase survival rates.