|SSM Cardinal Glennon Children's Medical Center|
Chronic Myelogenous Leukemia (CML)
Leukemia is a type of cancer that affects the body's white blood cells (WBCs).
Normally, WBCs help fight infection and protect the body against disease. But in leukemia, WBCs turn cancerous and multiply when they shouldn't, resulting in too many abnormal WBCs, which then interfere with the body's ability to function normally.
If too many mature WBCs are made, a child will develop chronic myelogenous leukemia (CML). While this type of leukemia is more common in adults, it can affect children, too.
Thanks to advances in therapy and clinical trials, the outlook for kids with CML is promising.
CML is caused by a chromosomal problem. The 23 pairs of chromosomes in the body each contain segments of DNA called genes. Genes are essentially the body's blueprints.
CML occurs when a piece of chromosome 22 breaks off and switches places with a piece of chromosome 9. (This piece, containing parts of both chromosome 9 and chromosome 22, is known as the Philadelphia chromosome.) The combination results in the cancer gene known as BCR-ABL. This is the gene that instructs the body to make too many mature WBCs.
Although researchers know what genes are involved in the development of CML, they do not yet know why some people get it and others do not.
Signs and Symptoms
CML tends to progress slowly, so at first a child may have few if any symptoms. In fact, symptoms can take months or even years to develop. The symptoms of all types of leukemia are generally the same and include:
Often no symptoms appear for quite a while with CML, so it's commonly discovered when a child has a routine blood test for other reasons. A doctor who suspects a child has leukemia might order these tests:
Treatment of CML takes into account things like the phase of the leukemia (whether it's in the early or later stages of the disease), the amount of cancerous cells in the body, and how well the other organs of the body are working. This information, in addition to a child's age and overall heath, helps doctors develop treatment plans that may include these options:
After treatment begins, the goal is remission (when there is no longer evidence of cancer cells in the body). Once remission has occurred, maintenance chemotherapy is usually given to keep a child in remission and to keep killing cancer cells. The effect of treatment is assessed regularly by measuring how many BCR-ABL genes are in the blood.
Being told that a child has cancer can be a terrifying experience, and the stress of cancer treatment can be overwhelming for any family.
Although you might feel like it at times, you're not alone. To find out about support that may be available to you or your child, talk to your doctor or a hospital social worker. Many resources are available that can help you get through this difficult time.
Reviewed by: Emi H. Caywood, MD