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What is Chronic myeloid leukaemia (CML)?

Chronic myelogenous leukaemia (CML) is an uncommon bone marrow malignancy. Bone marrow is the spongy substance found inside bones that produces blood cells. CML increases the quantity of white blood cells in the bloodstream.

The term chronic in chronic myelogenous leukaemia refers to cancer that progresses more slowly than severe kinds of leukaemia. The term myelogenous relates to the cells affected by this malignancy.

Chronic myelogenous leukaemia is also known as chronic myeloid or chronic granulocytic leukaemia. It mainly affects older adults and is infrequently seen in children, but can happen at any age.

Advances in treatment have improved the prognosis for persons with chronic myelogenous leukaemia.

What is the Importance of Timely Treatment?

Chronic Myeloid Leukemia (CML) must be treated as soon as possible to improve patient outcomes and manage the disease efficiently.

Early treatment can keep the disease from developing to the more aggressive blastic phase, which is more challenging to treat. Early therapy increases long-term survival rates and lowers the chance of complications, relapses, or progression to acute leukaemia, which has inferior outcomes.

Furthermore, timely therapy aids in the control of symptoms such as fatigue, weight loss, and pain, allowing patients to maintain a higher quality of life. Therefore, early and consistent therapy of CML is essential for better disease control, increased survival, and improved overall health.

What are the Common Symptoms of Chronic myeloid leukaemia (CML)?

Chronic myelogenous leukaemia is generally asymptomatic. A blood test may identify it. Symptoms may include:

  • Bone discomfort
  • Bleeding easily
  • Feeling satisfied after consuming a tiny quantity of food
  • Fatigue
  • Fever
  • You can lose weight without trying
  • Loss of appetite
  • Pain or fullness beneath the ribcage on the left side
  • Excessive sweating when asleep
  • Blurry vision is produced by bleeding in the rear of the eye

Stages of Chronic myeloid leukaemia (CML)

  • Chronic CML: The term chronic usually refers to a long-term condition. In CML, the phrase refers to the proportion of immature white blood cells (blasts) in your bone marrow and blood. In chronic CML, blasts account for approximately 10% of your blood and bone marrow cells.
  • Accelerated CML: Blasts account for 10% to 19% of cells in your blood or bone marrow during the Accelerated CML phase.
  • Blast (Blast Crisis) CML: Blast can be life-threatening. In blast CML, testing shows that blasts account for 20% or more of your bone marrow or blood cells.
  • Resistant CML: This refers to CML that recurs or does not respond to treatment.

Causes, Risk Factors and Complications of Chronic myeloid leukaemia (CML)

Causes

Chronic myelogenous leukaemia occurs when something changes the bone marrow cells.

  • A new chromosome develops.
    • In persons with chronic myelogenous leukaemia, the chromosomes in blood cells swap parts. A portion of chromosome 9 swaps positions with a section of chromosome 22. This results in a tiny chromosome 22 and an extremely long chromosome 9.
    • The extra-short chromosome 22 is known as the Philadelphia chromosome. 90% of chronic myelogenous leukaemia patients have the Philadelphia chromosome in their blood cells.
  • The Philadelphia chromosome generates a new gene.
    • The Philadelphia chromosome combines chromosomes 9 and 22 to form a new gene known as BCR-ABL. The BCR-ABL gene tells the blood cells to produce too much of a tyrosine kinase protein. Tyrosine kinase promotes cancer by allowing some blood cells to proliferate uncontrollably.
  • The new gene allows for too many unhealthy blood cells
    • Tyrosine kinase in chronic myelogenous leukaemia promotes the growth of excessive white blood cells. The Philadelphia chromosome is present in most, if not all, of these cells. The defective white blood cells do not develop and perish as they should.
    • The defective white blood cells accumulate in large numbers. They deplete healthy blood cells and harm the bone marrow.

Risk Factors

The following factors enhance the risk of chronic myelogenous leukaemia:

  • Older age: CML is more prevalent in older persons than children and teenagers.
  • Being Male: Men have a slightly higher risk of acquiring CML than women.
  • Radiation exposure: Radiation therapy for specific forms of cancer has been associated with CML.

Complications

Individuals with CML may develop:

  • Anaemia: This disorder develops when you do not have enough red blood cells.
  • Splenomegaly (enlarged spleen)

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Latest Research and Technologies in the Treatment of Chronic Myeloid Leukaemia (CML) in India

  • In India, the most recent research and technology in Chronic Myeloid Leukemia (CML) treatment focuses primarily on the use of low-cost generic versions of tyrosine kinase inhibitors (TKIs), which have significantly improved patient outcomes by making this targeted therapy available to a larger population, as well as ongoing research to overcome TKI resistance and explore potential treatment-free remission options for appropriate patients.

Chronic myeloid leukemia (CML) Prevention Tips

Some prevention tips for Chronic Myeloid Leukemia (CML):

  • Avoid radiation exposure
  • Minimise chemical exposure
  • Maintain a healthy lifestyle
  • Quit smoking as Smoking increases the risk of various cancers, including CML.
  • Regular health check-ups

These tips support overall health but cannot specifically prevent CML.

Treatment options for Chronic myeloid leukemia (CML)

Targeted therapy: Targeted therapy focuses on specific molecules in cancer cells, such as the tyrosine kinase protein in chronic myelogenous leukemia.


Cost Start From USD 8000 - USD 12000Explore Options

Bone marrow transplant: A bone marrow transplant heals chronic myelogenous leukemia, although it is only recommended for patients who have not received previous treatments due to the dangers and problems involved. High-dose chemotherapy destroys blood-forming cells, while donor blood stem cells replace damaged ones.


Cost Start From USD 25000 - USD 35000Explore Options

Chemotherapy: Chemotherapy employs potent medications to attack cancer cells. Medicines for chemotherapy are occasionally coupled with targeted therapy to treat aggressive chronic myelogenous leukemia.


Cost Start From USD 600 - USD 700Explore Options

The following tests and procedures diagnose Chronic myeloid leukaemia (CML):

  • Complete blood count (CBC): A complete blood count (CBC) may be performed to determine whether there are too many white or too few red blood cells.
  • Bone marrow aspiration or biopsy: Providers collect small amounts of fluid or tissue for genetic testing. A medical pathologist will run tests to determine the genetic makeup of aberrant cells.
  • Computed tomography (CT) scan: Providers utilise a computed tomography (CT) scan to assess whether CML impacts other sections of your body.
  • Ultrasound: Your provider may use this test to check whether your spleen is larger than usual. CML symptoms include an enlarged spleen.
  • Physical Therapy: Physical therapy enhances strength, mobility, and total physical function during and after treatment. Physical therapy can help CML patients recover and maintain their activity levels.
  • Cognitive Rehabilitation: Some CML patients may have "chemo brain," including memory or attention difficulties. Cognitive therapy can help to improve mental function and concentration.
  • Occupational Therapy: Occupational therapy assists patients in regaining daily and work-related skills. Occupational therapists can help with changes to the home or work environment to accommodate fatigue or physical restrictions.
  • Dietary Management: Eating a well-balanced diet can help you retain strength, control prescription side effects, and improve overall health.

MediGence can assist and guide you in selecting the best physician and medical facility for your care.

Depending on the circumstances, your doctor may prescribe medication to assist you in managing your symptoms and support your treatment plan.

Treatment regimens are adapted to the patient's specific cancer stage and location.

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Hospitals for Chronic myeloid leukemia (CML) in India

Sri Ramachandra Medical Centre: Top Doctors, and Reviews
Sri Ramachandra Medical Centre

Chennai, India

Sri Ramachandra Medical Centre located in Chennai, India is accredited by ISO, JCI, NABH, NABL. Also listed below are some of the most prominent infrastructural details:

  • The best minds in healthcare including specialists, and other healthcare professionals work together to treat patients with simple to complex and critical conditions.
  • The number of inpatients and outpatients (annually) are 35,000 and 2,50,000 respectively.
  • A wide range of surgical specialties, sub specialties are available in Sri Ramachandra Medical Centre Chennai.
  • The bed capacity of the hospital is 800 which is inclusive of 200 Intensive Care Unit beds.
  • Blood Bank and Eye Bank are available on a 24/7 basis.
Seven Hills Hospital: Top Doctors, and Reviews
Seven Hills Hospital

Mumbai, India

Seven Hills Hospital located in Mumbai, India is accredited by JCI, NABH, NABL. Also listed below are some of the most prominent infrastructural details:

  • It is spread over an area of 17 acres.
  • There is also an academic institute with research facilities.
  • SevenHills Hospital has excellent diagnostic services including a laboratory and a provision for various tests.
  • Given that their are specific departments for various kinds of diagnostsic. Tests like PET Scan, MRI, CT scan and biopsies are completed regularly.
  • Biochemistry, Hematology, Microbiology are some of the important diagnostic departments.
  • Endoscopies as well as non-invasive procedures are done through their respective departments.
  • Day care specialty services are available for those kinds of requirements.
  • Health Check up packages are also present as are the collaborations with many insurance organisations.
  • There are professionally managed in-patient and out-patient facilities.
  • There are more than 30 super specialties in Seven Hills Hospital Mumbai.
  • There are also Centres of Excellence in Cardiac Care, Neurosciences, Bone & Joint Care, Cancer Care, Nephrology and Cosmetic Dermatology.
  • International patient care services are also implemented for the best assistance to overseas patients.
Fortis Hospital, Shalimar Bagh: Top Doctors, and Reviews
Fortis Hospital, Shalimar Bagh

Delhi, India

  • Fortis Hospital, Shalimar Bagh, New Delhi, is a leading multi-super-speciality hospital established in 2010, known for advanced medical technology and compassionate patient care.
  • The hospital has 375 beds, including 166 ICU beds, and features 10 modular operating theatres along with specialised ICUs and Level III NICU/PICU. Fortis Shalimar Bagh offers care across Cardiology, Neurosciences, Oncology, Orthopaedics, Transplants, Urology, and Mother & Child Health, supported by NABH and NABL accreditation.
  • Equipped with cutting-edge technology like the Da Vinci Surgical Robot, PET-CT Scanner, and CORI Robotic System, the hospital is recognised for excellence in treatment outcomes, patient comfort, and multidisciplinary care, making it a trusted destination for both domestic and international patients.

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Why Choose India for Chronic myeloid leukemia (CML) Treatment?

Here are some of the reasons for choosing India:

  • Due to advancements in medical facilities, such as minimally invasive surgical techniques.
  • World-class experts include highly experienced doctors, JCI, and NABH-accredited healthcare institutions.
  • Compared to other countries, treatment in Indian hospitals is cost-effective.
  • Indian hospitals provide International patient services, including a multilingual support system.
  • Improved treatment methods and biological therapies

Frequently Asked Questions

The success rate is excellent, particularly if the condition is detected early. TKIs work well for 80-90% of patients, resulting in long-term remission and excellent disease management.

Although recurrence is uncommon, it can occur, particularly if the disease is not properly controlled or the patient grows resistant to treatment. Relapsed CML can be managed by regular monitoring and treatment changes.

Side effects differ depending on the specific tyrosine kinase inhibitors (TKIs), but may include:

  • Stomach ache.
  • Fatigue.
  • Diarrhea.
  • Muscle cramping.
  • Edema.
  • Pleural effusion (fluid collection around the lungs).
  • Pancreatitis.
  • Damage to your liver.
  • Low white blood cell and platelet levels.

Yes, India has several specialist cancer centers that provide cutting-edge CML therapy, including access to clinical trials and novel treatments.

Yes, it can. CML patients may be more likely to develop other types of cancer (second malignancies). A recent study found that approximately 30% of persons with chronic myeloid leukemia got second malignancies, including:

  • Small intestine cancer
  • Thyroid cancer
  • Stomach cancer
  • Lung cancer
  • Prostate cancer

CML can occur anywhere in India, although there is no compelling evidence that it is more prevalent in any particular region. However, healthcare accessibility and awareness may differ by geography, with better diagnosis and treatment available in major cities.

Stem cell transplants are explored when the illness does not respond to TKIs or there is a relapse. The surgery is accessible at many major hospitals across India, although it is typically chosen as a last resort due to its complexity and cost