Chronic leukemia is called chronic myeloid leukemia (CML) or chronic myelosis for short . This is usually genetic damage in the bone marrow, which is followed by increased formation of leukocytes . Leukocytes are better known as the white blood cells. These accumulate specifically as granulocytes in the blood and in the blood-forming bone marrow.
Chronic leukemia – genetic damage in the bone marrow
Initially, the disease occurs without symptoms. It exists in the form of a chronic myeloproliferative disease (MPE) that results from abnormalities in the stem cells.
New forms of treatment usually improve the prognosis of CML. With the help of targeted therapies, there are relatively few side effects.
First signs of CML
Those affected who develop CML initially show no symptoms. Signs usually only appear during a blood test. Since there are no or only minor signs, CML appears as an incidental finding in the blood count. If the doctor diagnoses altered genetic material, chronic leukemia is present. Blood cells, which act as oxygen transporters in the blood, decrease in CML.
In the worst case, anemia can occur. A differential blood count helps to determine the exact disease and to examine its course. Here, the type and number of white blood cells are determined. Especially in the case of CML, mature granulocytes and immature progenitor cells are present in this blood count .
The course of the disease is divided into three phases. At the beginning there is the chronic phase. It proceeds slowly and insidiously. In addition to leukocytosis, there is usually an enlargement of the spleen. This displaces healthy blood formation from the bone marrow.
Extramedullary blood formation in the spleen and liver follows. The acceleration phase initiates the transition between the chronic phase and the blast phase. Anemia worsens your health. The blast surge follows relatively suddenly. Without treatment, this stage ends in death.
Therapies and treatment prospects in CML
Successful treatment of chronic leukemia is no longer considered a rarity. Tyrosine kinase inhibitors represent a milestone in therapy. They help patients suffering from chronic leukemia live a long and relatively pain-free life.
The life-threatening blood cancer develops through them into an easily treatable disease. One goal of treatment is to control the symptoms. The reduction and ideally the elimination of the leukemia cells is the main aim.
To cure CML, sufferers need a blood stem cell transplant. This results in a complete replacement of the bone marrow. Allogeneic transplantation does not present itself as a form of treatment in all patients. There is usually a difficulty in finding a suitable donor. Furthermore, this therapy carries life-threatening risks. There is a possibility that the body will have a counter-reaction to the donated stem cells.
In contrast, the targeted therapy works within the cancer cell. The desired effect occurs directly on the cancer-causing complex. The BCR-ABL protein is responsible for chronic leukemia. It exists as a tyrosine kinase and promotes uncontrolled multiplication of leukemia cells.
A tyrosine kinase inhibitor blocks this protein and stops the increase in harmful cells . Those affected take the inhibitors for life in order to constantly control the CML. This standard therapy does not guarantee tolerability for all patients. The therapy history, concomitant diseases and intolerances are highly relevant as individual factors. Ultimately, the doctor, in consultation with the patient, determines which therapy has the greatest possible success in treating chronic leukemia. In some cases, there is a possibility that therapies will not show effects or lose them. Genetic abnormalities impede the effectiveness of the medication.
It is drug resistance. In such a case, patients have alternative therapies available. A normally high life expectancy with a good quality of life does not seem unreasonable.
