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    Advanced Phases of Chronic Myelogenous Leukemia

    By Jennifer Clopton
    WebMD Feature
    Reviewed by Lisa Bernstein, MD

    If you're in the later stages of chronic myelogenous leukemia (CML), there's a wide variety of ways you may feel. Some people have fever, lose their appetite, and drop a few pounds. But others don't have any symptoms.

    No matter how your disease affects your body, make sure you get the emotional support you need. Talk to your friends and family and keep up with contacts you've made in support groups. They can be huge sources of help while you manage your health. 

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    Even if you don't have any symptoms, it's important to have regular visits to your doctor. He may take blood tests that can check if your chronic myelogenous leukemia -- also known as chronic myeloid leukemia -- has moved into an advanced stage.

    Why Does CML Get Worse?

    For most people with CML, medications prevent the disease from moving to its later stages.

    But it can still happen. About 10% to 15% of CML patients reach the advanced stages of the disease, says Elias Jabbour, MD, a leukemia expert at the University of Texas M.D. Anderson Cancer Center in Houston.

    It can happen if you don't take your meds, if your disease was already advanced when doctors found it, or if your body stops responding to the medication you're taking.

    The Accelerated Phase

    The first stage of CML, called the chronic phase, is the easiest to treat. But if your diseases advances, you may move into the "accelerated" phase. When this happens, abnormal blood cells and platelets (which help stop bleeding) begin to crowd out normal ones. Several gene glitches cause that, saysJerald P. Radich, MD, of Seattle's Fred Hutchinson Cancer Research Center.

    You can also go into this phase if you develop very high or low platelet counts or high white blood cell counts that don't respond to treatment.

    What Is CML Blast Crisis?

    You move into the blast phase when blast cells, another type of white blood cell, make up more than 20% of your blood or bone marrow (the place in your bone where blood cells are made).

    During this period, infections and bleeding are common and without treatment can be life-threatening. Fever, loss of appetite, weight loss, and fatigue can get worse.

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