Chronic myeloid leukemia (CML) Treatment in Singapore

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 it 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)

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

• Advanced CML therapies in Singapore include single-cell RNA sequencing for individualised treatment and improved remission results, AI-driven drug resistance prediction, and targeting genetic variables such as MCL-1.

Chronic myeloid leukemia (CML) Prevention Tips

Some prevention tips for Chronic Myeloid Leukaemia (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.