NCCN Guidelines for Patients® | Chronic Myelogenous Leukemia - page 22

NCCN Guidelines for Patients
: Chronic Myelogenous Leukemia
Version 1.2014
3.1 Chronic phase
The accelerated phase is the second phase of CML. In this phase, the number
of blast cells in the peripheral blood and/or bone marrow is usually higher than
normal. Other aspects of accelerated phase can include increased basophils,
very low platelets, or new chromosome changes. The number of white blood cells
is also high. In this phase, the leukemia cells grow more quickly and may cause
symptoms such as anemia and an enlarged spleen. A few different criteria groups
can be used to define accelerated phase. However, the two most commonly used
are the World Health Organization Criteria and the criteria from MD Anderson
Cancer Center. See Table 2.
The chronic phase is the first phase of CML. In this phase, the number of white
blood cells is increased and immature white blood cells (blasts) make up less
than 10% of cells in the peripheral blood and/or bone marrow. This means that
less than 10 out of every 100 cells are blasts. CML in the chronic phase may
cause mild symptoms, but most often it does not cause any symptoms. Possible
symptoms include feeling unusually tired and a feeling of fullness near the belly.
The body can still fight infections since the changes in blood cells are not severe.
In this phase, the cancer progresses very slowly. Thus, CML in the chronic phase
may progress over several months or years. In general, people with CML in the
chronic phase respond better to treatment.
3.2 Accelerated phase
A health condition
in which the number of red
blood cells is low
A type of white
blood cell that helps fight
infection in the body
Bone marrow:
Soft tissue
in the center of most bones
where blood cells are made
strand of bundles of coded
instructions in cells for
making and controlling cells
Peripheral blood:
outside of the bone that
travels throughout the body
Blood cell that
helps control bleeding
blood cell that forms a type
of mature white blood cell
An organ to the
left of the stomach that
helps protect the body from
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