If you were diagnosed during the chronic phase of chronic myelogenous leukemia (CML), you may have felt fine most of the time and lived a fairly normal life. But if you've entered the CML accelerated phase or blast phase, things have likely changed. You may feel sick and weak and have a wide range of symptoms.
To cope with CML now, it well help to work even more closely with your doctors and to better understand what's going on inside your body.
When the CML Chronic Phase Ends
Chronic myelogenous leukemia is a disease of the bone marrow. As you may know, CML tends to get worse more slowly than other types of leukemia.
"During the CML chronic phase, your blood cell-making program simply shifts into high gear and pumps out more of the normal spectrum of blood cells," says Jerald P. Radich, MD, of the Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance. As a result, your white blood count can increase by as much as 10 or 20 times, he says.
Today, medications can be very effective during the CML chronic phase, allowing many people to live free or nearly free of symptoms for years. These drugs are often very successful at blocking the protein made by the BCR-ABL cancer gene. It is this Philadelphia chromosome that basically drives everything at this stage of CML, Radich says.
But perhaps your CML was caught late or you were unable to take medications. Maybe your disease became resistant to medication, or treatment stopped working for a reason that is not yet well understood.
As you enter the CML accelerated phase or blast phase, other changes begin to occur as well. The Philadelphia chromosome no longer drives your disease alone, Radich says. "You've accumulated a number of other genetic abnormalities besides BCR-ABL," he says. These have also moved into the driver's seat. Now, abnormal cells begin to crowd out normal blood cells and platelets, which are involved with blood clotting.
Coping with CML now becomes a new kind of experience.