HYDERABAD: Chronic Myeloid Leukaemia (CML) is one of those diseases that has gone from being life-threatening to a manageable chronic condition for most patients. With the possibility of longer life and fewer side effects, people with CML need to deal with the disease proactively and maintain consistency with follow-ups.
With the help of city-based doctors, we decode the disease, its symptoms, risks and how to manage the condition.
“Chronic Myeloid Leukaemia (CML) is often misunderstood, with patients sometimes confusing it with other forms of Leukaemia. In CML, the uncontrolled growth of white blood cells in the bone marrow defines its characteristic features,” says Dr A V S Suresh, Senior Consultant Medical Oncologist & Haematologist at Continental Hospitals.
He explained that CML progresses through three distinct phases: chronic, accelerated, and blast. The chronic phase constitutes about 90% of CML cases. “This phase can extend over several years, but if left untreated, CML can advance to the accelerated and blast phases,” he said.
“In the accelerated phase, the disease progresses more rapidly, and blast cells, which are immature blood cells, start to increase. If CML reaches the blast phase, the number of blast cells rises significantly, crowding out healthy blood cells. This can lead to severe symptoms and complications, requiring more aggressive treatments such as stem cell transplants,” he explained.
Elaborating on the symptoms of CML, Dr Suresh said, “Night sweats, weight loss, fever, bone pain, and an enlarged spleen may manifest, especially as the disease progresses beyond the chronic phase. While some patients may experience these symptoms early on, others may not, and these indicators often improve with treatment initiation.”
This is why adherence to medication and regular monitoring of BCR-ABL levels plays an important role when it comes to CML management, he adds.
A disease that affects over a million people globally, its diagnosis can be daunting due to the term ‘blood cancer’. However, patients and families need to understand that CML is a chronic but treatable condition, remarks Dr Ganesh Jaishetwar, Lead Consultant and Head, Department of Haematology and Bone Marrow Transplant, Yashoda Hospitals.
“I see about four to five new cases of CML every month. In India, the median age of CML patients is between 40-50 years, younger than the global average by ten years,” he told CE.
Dr Jaishetwar notes that many CML patients can achieve good disease control and lead fulfilling lives with advancements in medical technology and ongoing developments in drug therapies. “Based on my experience, around 80-90% of patients maintain a high quality of life with regular medication and monitoring,” he reassures.
It is important to note that although manageable, CML can progress if not monitored. With timely interventions and monitoring, challenges like medication resistance or side effects can be avoided. According to Dr Jaishetwar, monitoring haematological parameters and molecular response, as per ELN (The European LeukemiaNet) guidelines, improves long-term disease control. Even more important is to stay positive, follow the doctor’s advice, and follow regular follow-ups for a normal quality of life.
Adding to this, Dr G Sadashivudu, Head of Department of Medical Oncology, NIMS, says, “I have encountered patients of all ages, from nine to sixty years old, who have been diagnosed with blood cancer. Upon receiving a diagnosis of CML, many patients undergo severe emotional distress. It’s crucial to provide them with proper counselling.”