What Is Chronic Myeloid Leukemia?
Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas of the body. To learn more about how cancers start and spread, see What Is Cancer?
Chronic myeloid leukemia (CML), also known as chronic myelogenous leukemia, is a type of cancer that starts in certain blood-forming cells of the bone marrow. In CML, a genetic change takes place in an early (immature) version of myeloid cells - the cells that make red blood cells, platelets, and most types of white blood cells (except lymphocytes). This change forms an abnormal gene called BCR-ABL, which turns the cell into a CML cell. The leukemia cells grow and divide, building up in the bone marrow and spilling over into the blood. In time, the cells can also settle in other parts of the body, including the spleen. CML is a fairly slow growing leukemia, but it can also change into a fast-growing acute leukemia that is hard to treat.
Most cases of CML occur in adults, but very rarely it occurs in children, too. In general, their treatment is the same as for adults.
What is leukemia?
Leukemia is a cancer that starts in the blood-forming cells of the bone marrow. When one of these cells changes and becomes a leukemia cell, it no longer matures normally. Often, it divides to make new cells faster than normal. Leukemia cells also don't die when they should. This allows them to build up in the bone marrow, crowding out normal cells. At some point, leukemia cells leave the bone marrow and spill into the bloodstream, often causing the number of white blood cells in the blood to increase. Once in the blood, leukemia cells can spread to other organs, where they can prevent other cells in the body from functioning normally.
Leukemia is different from other types of cancer that start in organs such as the lungs, colon, or breast and then spread to the bone marrow. Cancers that start elsewhere and then spread to the bone marrow are not leukemia.
Not all leukemias are the same. Knowing the specific type of leukemia helps doctors better predict each patient's prognosis (outlook) and select the best treatment.
What is a chronic leukemia?
Whether leukemia is acute or chronic depends on whether most of the abnormal cells are immature (and are more like stem cells) or mature (and are more like normal white blood cells).
In chronic leukemia, the cells can mature partly but not completely. These cells may look fairly normal, but they are not. They generally do not fight infection as well as normal white blood cells do. The leukemia cells survive longer than normal cells, and build up, crowding out normal cells in the bone marrow. Chronic leukemias can take a long time before they cause problems, and most people can live for many years. But chronic leukemias are generally harder to cure than acute leukemias.
What is a myeloid leukemia?
Whether leukemia is myeloid or lymphocytic depends on which bone marrow cells the cancer starts in.
Myeloid leukemias (also known as myelocytic, myelogenous, or non-lymphocytic leukemias) start in early myeloid cells -- the cells that become white blood cells (other than lymphocytes), red blood cells, or platelet-making cells (megakaryocytes) .
What are the other types of leukemia?
There are 4 main types of leukemia, based on whether they are acute or chronic, and myeloid or lymphocytic:
- Acute myeloid (or myelogenous) leukemia (AML)
- Chronic myeloid (or myelogenous) leukemia (CML)
- Acute lymphocytic (or lymphoblastic) leukemia (ALL)
- Chronic lymphocytic leukemia (CLL)
In acute leukemias, the bone marrow cells cannot mature the way they should. These immature cells continue to reproduce and build up. Without treatment, most people with acute leukemia would only live a few months. Some types of acute leukemia respond well to treatment, and many patients can be cured. Other types of acute leukemia have a less favorable outlook. Lymphocytic leukemias (also known as lymphoid or lymphoblastic leukemia) start in the cells that become lymphocytes. Lymphomas are also cancers that start in those cells. The main difference between lymphocytic leukemias and lymphomas is that in leukemia, the cancer cell is mainly in the bone marrow and blood, while in lymphoma it tends to be in lymph nodes and other tissues.
Chronic myelomonocytic leukemia (CMML) is another chronic leukemia that starts in myeloid cells. For more information on this type of cancer, see Leukemia: Chronic Myelomonocytic.
The rest of this information is only about chronic myeloid leukemia (CML).
Last Medical Review: February 24, 2015 Last Revised: February 22, 2016