Chronic Myelogenous Leukemia

Chronic myelogenous leukemia (CML) is a slow-progressing leukemia associated with a specific genetic abnormality in the leukemia cell, called the Philadelphia chromosome. This abnormal gene is produced when genetic material called ABL is displaced from chromosome 9 and replaces the normal part of chromosome 22 next to a region called BCR. The resulting fusion gene, BCR/ABL, causes abnormal function of the ABL gene, which leads to the leukemia.

There are three main phases of CML:

• The disease almost always starts in the chronic phase, during which the disease is usually easy to control with treatment, and patients can lead nearly normal lives.
• The disease may progress over a few years into the accelerated phase. When this happens, the blood counts worsen and patients can experience high fever, bone pain and painful enlargement of the spleen.
• The blast phase of CML is a form of acute leukemia that is very difficult to treat. Two-thirds of the time it is myeloid, and is considered acute myeloid leukemia. One-third of the time, it is lymphoid (acute lymphoblastic leukemia, or ALL). Survival is usually only a matter of months once the blast phase occurs.

Our Approach to Chronic Myelogenous Leukemia

UCSF is dedicated to delivering the most advanced treatment options for chronic myelogenous leukemia (CML) with care and compassion. For most patients with early-stage CML, mainstay medications called tyrosine kinase inhibitors are effective in controlling the disease for many years, and they usually prevent it from progressing to the dangerous final phase. Should standard treatments fail, UCSF offers stem cell transplants as well as access to clinical trials of potential new therapies.