Chronic Myeloid Leukemia (CML) is a malignancy of the blood and bone marrow characterized by uncontrolled white blood cell proliferation. It is caused by a genetic anomaly known as the Philadelphia chromosome, which is a translocation of chromosomes 9 and 22, resulting in the creation of the BCR-ABL1 gene. This fusion gene creates an aberrant protein called tyrosine kinase, which causes an overproduction of immature white blood cells, specifically granulocytes. These cells do not mature properly and amass in the bone marrow and bloodstream, displacing healthy cells like red blood cells and platelets. CML normally advances in three stages: chronic, rapid, and blast crisis. Patients in the chronic phase may be asymptomatic or exhibit modest symptoms such as weariness, weight loss, and abdominal discomfort. Most people are diagnosed during this period, which might last several years. Without therapy, CML may progress to the accelerated phase, which is characterized by quicker proliferation of aberrant cells and more severe symptoms. Finally, the blast crisis phase resembles acute leukemia, in which immature cells multiply rapidly, causing severe symptoms and consequences. Early diagnosis and treatment during the chronic phase significantly improves outcomes. Blood tests, bone marrow biopsy, and genetic testing to detect the Philadelphia chromosome or BCR-ABL1 fusion gene are frequently used in the diagnostic process. Treatment tries to lower the number of aberrant cells, alleviate symptoms, and increase life expectancy. Traditional chemotherapy was once the major treatment for CML, but with the introduction of targeted medicines such as tyrosine kinase inhibitors (TKIs), the prognosis has significantly improved. TKIs, such as imatinib, dasatinib, and nilotinib, selectively target the BCR-ABL1 protein, reducing its function and preventing leukemia cell proliferation. These medications are frequently quite effective, allowing the majority of patients to achieve remission and live nearly normal lives. Despite these advances, some people may develop resistance or intolerance to particular TKIs, necessitating alternate therapy such as second-generation TKIs or stem cell transplantation in rare situations. Regular monitoring using blood and molecular testing is required to track response to treatment and alter therapy as needed. With careful management, many people with CML can live for many years while effectively controlling their illness.
