Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Chronic myeloid leukemia

6,894 views

Published on

Published in: Health & Medicine
  • Be the first to comment

Chronic myeloid leukemia

  1. 1. Chronic Myeloid Leukemia By Ganna (Anya) Brych
  2. 2. General Overview • Also called: -chronic myelogenous leukemia -chronic granulocytic leukemia -chronic myelocytic leukemia. • mostly affects adults (chance increases in people 65 and older) • Can develop in children/younger people • Epidemiology= Can not be transmitted • Prognosis = live good-quality lives with medication
  3. 3. Symptoms • Some don’t have symptoms in first stages Possible symptoms: -Leukopenia (shortage of normal white blood cells) -Neutropenia (low levels of normal neutrophils) -Thrombocytopenia (shortage of blood platelets) -Bleeding and bruising -Anemia -Shortness of breath
  4. 4. Symptoms (cont.) Possible symptoms (cont.) : -Feeling of fullness in the abdomen -Fever -Enlarged lymph nodes -Night sweats -Weight loss -Loss of appetite -Recurrent infections
  5. 5. Diagnosis • Blood Tests - a complete blood count (CBC) - lower-than-normal red cell count - abnormal number of platelets (either too high or too low) - High white cell count - a blood cell examination (test for leukemic blast cells and marrow cells) - high proportion of white cells
  6. 6. Diagnosis (cont.) • Bone Marrow Tests - bone marrow aspiration (remove a liquid marrow sample) - bone marrow biopsy (remove a small amount of bone marrow) • measure the number/structure of chromosomes • determine any chromosome abnormality (Ph chromosome) • confirm blood test findings
  7. 7. Diagnosis (cont.) • Hematopathologist confirms the diagnosis + identifies the phase • Looks for: -presence of the Philadelphia chromosome -number of cells with the Bcr-Abl oncogene Can Perform: • Cytogenetic analysis - identifies certain changes in chromosomes and genes by use of a karyotype • Fluorescence in situ hybridization (FISH) - detects Bcr-Abl using fluorescent dyes • Polymerase chain reaction (PCR) - identify and measure Bcr-Abl oncogenes not found by “FISH”
  8. 8. Causes • Risk factors -exposure to very high doses of radiation -high-dose radiation therapy (radiotherapy) • Abnormal chromosome (Philadelphia or Ph chromosome) = translocation between chromosomes 22 and 9 • Causes development of cancer-causing gene (oncogene) Bcr-Abl
  9. 9. Development • oncogene causes production of mutated protein called Bcr-Abl tyrosine kinase by stem cells • starts with a mutation to a single stem cell (in the bone marrow) • Stem cells form blood cells • multiplies into many cells • The CML cells grow and survive better than normal cells • Uncontrolled growth of CML cells = cancerous
  10. 10. Phases • Each phase determined by the number of blast cells • Severity of symptoms increases • 3 Phases -Chronic Phase CML -Accelerated Phase CML -Blast Crisis Phase CML
  11. 11. Chronic Phase CML • symptoms are mild or not noticeable. • white cells can still fight infection. • long-term drug therapy can control chronic phase • return to normal activities after treatment begins.
  12. 12. Accelerated Phase CML • Low of red cells, • low number of platelets • an increase or decrease in white cells • a high number of blast cells • Symptoms may appear: -swollen spleen -stomach discomfort
  13. 13. Blast Crisis Phase CML • increased number of blast cells in marrow and blood • low red cell and platelet counts • Symptoms : -infection -bleeding -a lack of energy or feelings of tiredness -shortness of breath -stomach pain (from an enlarged spleen) -bone pain • effects similar to those caused by an acute leukemia
  14. 14. Treatment • 2001 FDA approved tyrosine kinase inhibitor drugs (most commonly used today) • Dose depends on the phase of CML • TKI drug therapy doesn't cure chronic phase CML -> stable remission • Regular blood and marrow tests to check progress of treatment
  15. 15. Chronic Phase Treatment • Tyrosine kinase inhibitor (TKI) drugs -imatinib mesylate (Gleevec®) -dasatinib (Sprycel®) -nilotinib (Tasigna®) • If Initial Therapy Fails -interferon alpha (Roferon®-A and Intron® A) -pegylated interferon alpha -hydroxyurea (Hydrea®) -cytarabine (Cytosar-U®) -busulfan (Myleran®) ** harsher side effects **
  16. 16. Accelerated Phase and Blast Crisis Phase Treatment • Tyrosine kinase inhibitor (TKI) drugs -imatinib mesylate (Gleevec®) -dasatinib (Sprycel®) -nilotinib (Tasigna®) • If Initial Therapy Fails -interferon -busulfan (Myleran®) -cytarabine (Cytosar-U®) -hydroxyurea (Hydrea®) • Leukapheresis (removal of white blood cells) • Stem cell transplant
  17. 17. Bibliography • "BCR Rearrangement–Negative Chronic Myelogenous Leukemia Revisited." Journal of Clinical Oncology. American Society of Clinical Oncology, n.d. Web. 15 Mar. 2014. <http://jco.ascopubs.org/content/19/11/2915/F3.expansion>. • "Chronic Myeloid Leukemia (CML)." Learn About Cancer. American Cancer Society, n.d. Web. 15 Mar. 2014. • "Chronic Myeloid Leukemia." MedlinePlus. U.S. National Library of Medicine, n.d. Web. 15 Mar. 2014. <http://www.nlm.nih.gov/medlineplus/chronicmyeloidleukemia.htm l>.<http://www.cancer.org/cancer/leukemia- chronicmyeloidcml/index>. • "Chronic Myelogenous Leukemia." Leukemias. Memorial Sloan Kettering Cancer Center, n.d. Web. 15 Mar. 2014. <http://www.mskcc.org/cancer-care/adult/chronic-myelogenous- leukemia>. • Shah, Neil P. "Chronic Myeloid Leukemia." Disease Information and Support. The Leukemia and Lymphoma Society, n.d. Web. 15 Mar. 2014. <http://www.lls.org/#/diseaseinformation/leukemia/chronicmyeloidleuk emia/>.

×