Chronic Myelogenous Leukemia (CML) is a malignancy that affects blood-forming cells in the bone marrow. It is defined by the unregulated proliferation of myeloid cells, which are immature white blood cells. This causes an overproduction of these cells, crowding out healthy blood cells in the bone marrow. The primary cause of CML is a genetic aberration known as the Philadelphia chromosome. This chromosome is the product of a unique genetic mutation in which sections of chromosomes 9 and 22 split and switch positions. This results in the formation of a fusion gene known as BCR-ABL1, which produces a protein that stimulates myeloid cell proliferation. CML normally advances through three stages: chronic, accelerated, and blast phases. During the chronic phase, which can span several years, the disease frequently manifests with minor or no symptoms. It is frequently discovered unintentionally during normal blood tests when large amounts of white blood cells are detected. As CML progresses to the accelerated phase, leukemia cells multiply and divide more rapidly. Fatigue, weight loss, abdominal pain, and an enlarged spleen are all symptoms that may worsen. If not treated properly, CML can advance to the blast phase, in which the cells become even more aggressive and act similarly to acute leukemia. This phase is more difficult to treat and has a less favorable prognosis. Treatment for CML has advanced significantly in recent years. Targeted therapy, specifically tyrosine kinase inhibitors (TKIs) like imatinib, nilotinib, dasatinib, and others, has transformed CML treatment. These medications inhibit the function of the BCR-ABL1 protein, thereby controlling the proliferation of leukemia cells. Many CML patients can attain long-term remission and a near-normal life expectancy using these drugs. Bone marrow transplants may be considered for people who do not respond well to TKIs or who have advanced stages. However, because of the hazards involved, this method is usually reserved for younger individuals. Regular monitoring with blood tests and other diagnostic techniques is critical for treating CML and changing medication as necessary. With advances in targeted medicines, the outlook for people with CML has greatly improved, allowing many to live happy lives with careful treatment and monitoring.
