Whether you’ve just been diagnosed with chronic myeloid leukemia (CML) or have been living with it for some time, you may not fully understand how this type of cancer is affecting your body’s blood cells. Take a look at this infographic and see what having CML really means for your body and your overall health.
CML is a type of cancer that begins in your bone marrow, where blood cells are produced.
Each cell in your body has genetic material that tells the cell how to act. This is DNA, and it’s housed inside the cell’s chromosomes. In CML, unusual changes to chromosomes cause bone marrow to produce too many of a type of white blood cell called granulocytes.
Over time, immature white blood cells, called blasts, start to accumulate. As the number of blasts continues to grow, it gets harder for bone marrow to produce normal white blood cells, red blood cells, and platelets.
Most people with CML have a particular gene mutation called the Philadelphia chromosome. Although it’s a genetic abnormality, the Philadelphia chromosome is not inherited, so you won’t pass it on to your children.
Children can develop CML, but it’s more likely to strike in middle age or later. It’s generally a slow-growing type of cancer.
Initially, you can have CML with only mild symptoms or none at all. Some early symptoms can be rather indefinable and may include general weakness, fatigue, and night sweats. You might also experience unexplained weight loss and fever.
Leukemia is cancer of the blood.
Your bone marrow produces three types of blood cells:
- white blood cells, which fight infection and disease
- red blood cells, which carry oxygen throughout your body
- platelets, which are necessary for blood to clot
With CML, you have an abundance of immature white blood cells. These blasts continue to pile up in your bone marrow and blood. As they reproduce, they crowd out and slow down production of healthy white blood cells, red blood cells, and platelets.
CML usually results in a high white blood cell count. Most of these white blood cells are ineffective blasts. So you’re actually low on normal, healthy white blood cells. This is called leukopenia. You may also be low on neutrophils, a type of white blood cell that fights bacterial infections. This is called neutropenia.
These white blood cell abnormalities increase your risk of contracting serious infections and other diseases. Some treatments for CML can cause neutropenia to worsen. Signs of infection include fever and fatigue.
A shortage of red blood cells is called anemia. Symptoms include general weakness and fatigue. Anemia makes your heart work harder. As it worsens, it can also lead to shortness of breath, irregular heartbeat, and chest pains. You might have cold hands and feet, and your skin may start to look pale. Certain treatments for CML can make anemia worse.
Thrombocytopenia is when you’re low on platelets. Because this interferes with clotting, you’re prone to bruising, even after minor bumps. You’ll also find that you bleed easily. Your gums may bleed after you brush your teeth, or you could have nosebleeds for no apparent reason. You might also notice tiny red or purple dots due to slight bleeding just under your skin (petechiae).
Not everyone with CML is low on platelets. In fact, it’s possible that you have too many. This is called thrombocytosis. However, those platelets may be defective, so bruising and bleeding can still be a problem.
As CML progresses, energy wanes. Infections and bleeding can worsen.
Bone marrow is part of the lymphatic system, and it’s where CML begins. Blood stem cells for white blood cells, red blood cells, and platelets are produced in your bone marrow.
Chromosomal abnormalities lead to the production of abnormal white blood cells. Over time, the abnormal white blood cells build up in your bone marrow and blood. As a result, you run out of room for healthy white blood cells, red blood cells, and platelets. It’s also more difficult for healthy new blood cells to develop.
The spleen is another important part of your lymphatic system. Part of its job is to filter and store extra blood. With CML, this can lead to a swollen or enlarged spleen.
One symptom of an enlarged spleen is pain on your left side, just below your ribs. You might also feel full, even when you haven’t eaten or have eaten very little. Over time, you may not have much of an appetite, which can cause you to lose weight. Weight loss can also be due to some medications used in the treatment of CML.
Some of the medications used to treat CML can cause cardiac symptoms. This is especially true if you have a history of cardiac disease or other health problems.
Unusual but serious side effects of some CML drugs include irregular heartbeat, left ventricular dysfunction, and congestive heart failure.
Sometimes, leukemia cells migrate from your bone marrow to the surface of the bone. Leukemia cells can also spread into your joints. One symptom of bone metastasis is bone and joint pain, and it’s likely to worsen as the disease progresses.
Some medications used to treat CML can cause muscle aches, cramps, and weakness.
Chemotherapy and other treatments for CML can lead to problems all along the digestive system. These may include nausea, vomiting, and heartburn. You might have inflammation of your mouth lining, throat, or gut. You could have diarrhea or constipation. Certain medications can cause you to lose your sense of taste and smell. This array of symptoms can lead to poor appetite and weight loss.
Chemotherapy drugs work by destroying fast-growing cells. A variety of these drugs are used to treat CML. Some, but not all, can lead to temporary hair loss. They can also affect your fingernails and toenails, making them brittle and weak. Other medications can cause skin problems, such as rash, sensitivity, and itchiness.
Cancer and cancer treatment can affect your mental health and emotional well-being. It’s not unusual to feel sadness, anxiety, fear, or frustration. Some people go through a period of grieving.
When combined with fatigue, pain, and other physical effects, it can sometimes lead to clinical depression.