Acute myeloid leukemia symptoms and course

Know the course of chronic myeloid leukemia

In an examination by the (family) doctor, one normally does not expect a serious diagnosis. Patients who are then diagnosed with chronic myelogenous leukemia (CML for short) often wonder what will happen to them now.

How is the disease progressing? What symptoms should a patient expect? What symptoms might have been more indicative of the disease? How does normal life go on now and is that even possible?

Chronic myeloid leukemia (CML) is a malignant disease of the bone marrow. Leukemia is popularly known as blood cancer .

As with other forms of leukemia, too many white blood cells are made by the bone marrow in chronic myeloid leukemia (CML). Even if the diagnosis of an oncological disease is primarily devastating for those affected, chronic myeloid leukemia (CML) is no reason to become hopeless.

The treatment options have been almost revolutionized in recent years. This has made it possible to develop drugs that can precisely address the cause of the disease.

With the help of these drugs, patients can ideally enjoy an almost normal everyday life and expect a good quality of life. However, chronic myeloid leukemia (CML) is currently not curable. With the help of current studies, it is currently being investigated whether drugs can also bring about a cure for chronic myeloid leukemia (CML).

Chronic myeloid leukemia symptoms

As with any condition, if symptoms persist, it is important to see a doctor to get them checked out. The symptoms of chronic myeloid leukemia mentioned are rather unspecific and usually point to another, much more harmless disease.

If symptoms are observed, a doctor should be consulted. If chronic myeloid leukemia is suspected, this suspicion should be reported to the doctor so that the diagnosis can be adjusted accordingly and the doctor can usually calm the patient down.

Chronic myeloid leukemia is a malignant, chronic disease that is neither hereditary nor contagious or transmissible.

Since the symptoms are rather non-specific, it often happens when the diagnosis is made that the disease is discovered as an incidental finding before it shows more serious symptoms as the disease progresses.

The first symptoms of chronic myeloid leukemia can be:

• Tiredness, listlessness, reduced performance, exhaustion, shortness of breath and paleness. The cause of these symptoms is anemia
• depressed mood, depression
• Fever, feeling sick, although there is no infection or illness
• weight loss
• night sweats
• As the disease progresses, the spleen can become enlarged, which can lead to a feeling of pressure in the upper left abdomen

The suspicion of chronic myeloid leukemia usually arises during a routine blood test by the (family) doctor. Signs of the disease are very high levels of white blood cells. The number of platelets in the patient’s blood may also be increased. An examination of the bone marrow is required to make a reliable diagnosis.

This examination must be carried out by a doctor specializing in hematology and oncology. Bone marrow is removed from the hip or breastbone with a syringe. The area will be anesthetized locally beforehand. The subsequent laboratory examination shows the external and genetic changes in the affected cells in the case of the disease.

These disease characteristics can only be proven by these special examination methods and are essential for a reliable diagnosis.

Chronic myeloid leukemia course

Unlike other leukemia diseases , the course of chronic myeloid leukemia is lengthy and can be divided into three phases:

1st phase: The chronic phase

The diagnosis is usually made in the chronic phase of the disease. As the treatment in more advanced phases (2nd and 3rd phase) is considerably more difficult, it is particularly important to start treatment as soon as the diagnosis is made.

By taking modern medicines, the symptoms of blood formation can be reduced to the detection limit in this first phase. Those affected can often lead a completely normal life without symptoms. Doctors refer to this condition as remission.

2nd phase: The accelerated phase

If chronic myeloid leukemia progresses without treatment, the chronic phase is followed by the second phase of the disease. The so-called accelerated phase is characterized by a significant deterioration in the blood values ​​of the blood count.

More so-called blasts (immature precursors of blood cells ) are detected in the blood. In addition, changes in the genetic material in the blood can be detected in this phase. With appropriate treatment and drug therapy, chronic myeloid leukemia at this stage can be pushed back into the chronic phase.

3. Phase: Blastenkrise

The third phase is the so-called blast crisis and characterizes the progressive course of the disease. The blast crisis of chronic myeloid leukemia is very similar to the other, acute forms of leukemia, since more blasts are formed in the bone marrow.

These altered progenitor cells of normal blood cells impede the development of normal blood cells, which is associated with massive anemia. Patients with chronic myeloid leukemia in this phase are also much more susceptible to infections and tend to bleed and bruise.

The blast crisis characterizes acute chronic myelogenous leukemia and is a serious disease which, if left untreated, can lead to the death of the affected person within a few weeks.

Chronic myeloid leukemia is, as the name suggests, a chronic disease that can currently be treated well, but cannot be cured.

According to the latest state of the art, the aim of drug therapy is to contain the disease and prevent chronic myeloid leukemia from progressing to further phases. The success of the treatment is checked in regular examinations. The better a patient responds to the therapy, the better the long-term prognosis for the person concerned. Comprehensive control of the disease is more likely with successful drug therapy.

Drug therapy options include chemotherapy . If the patient does not respond to this therapy and the chronic myeloid leukemia continues to progress, a stem cell transplant can help and be necessary in some cases.

Chronic myeloid leukemia therapy studies

Many patients with chronic myeloid leukemia are treated in Germany in so-called therapy studies. The treatment is usually more extensive and uses the latest scientific findings.

The treatment in therapy studies is usually more comprehensive than standard therapy, as it uses innovative, newest drugs and current treatment strategies that are continuously being developed. Important to know: The treatment within the study does not mean that drugs are experimentally tested on those affected.

The aim of therapy studies in the treatment of chronic myeloid leukemia is to develop better and better treatment methods for the future. The decision on the appropriate therapy study is made together with the attending oncologist after detailed consultation. Various criteria such as the phase of the disease, disease characteristics and symptoms, previous treatment, age and other risk factors play a role in the choice of therapy study.

The final decision to participate in the therapy study is always made by the person concerned.

Sources:
Andreas Hochhaus, Ute Berger, Rüdiger Hehlmann (authors): “Chronic myeloid leukemia – recommendations for diagnosis and therapy”, Uni-Med Verlag, November 2004
Guide for patients: “Chronic myeloid leukemia”, publisher: German Leukemia and Lymphoma Foundation , May 2017