NCCN Guidelines for Patients® | Chronic Myeloid Leukemia

12 NCCN Guidelines for Patients ® : Chronic Myeloid Leukemia, 2018 1 CML basics Review fullness under the left side of the ribs. Your body can still fight germs since blood counts are close to normal. CML progresses very slowly in the chronic phase. It may take several months or years to reach the next phase. Compared to other phases, CML in the chronic phase tends to respond better to treatment. Accelerated phase The second phase of CML is called the accelerated phase. In this phase, the number of blasts is higher than normal. The number of white blood cells is also high. There may also be a very low number of platelets in the blood. In all phases, CML cells contain the Philadelphia chromosome. However, in the accelerated phase, there may be new abnormal changes within chromosomes. In the accelerated phase, CML cells may grow fast. You may have symptoms. Such symptoms may include fever, weight loss without dieting, and not feeling hungry. You may also have an enlarged spleen. Blast phase The third and final phase of CML is called blast phase. It is also referred to as “blast crisis.” Once CML is in blast phase, it can be life-threatening. In the blast phase, the number of blasts is very high. The blasts may have spread outside the blood or marrow to other tissues. Symptoms are common. They may include infections, bleeding, belly pain, and bone pain. CML cells become more abnormal. They often act like acute leukemia. Acute leukemia worsens very fast. Types of acute leukemia are AML ( a cute m yeloid l eukemia) and ALL ( a cute l ymphoblastic l eukemia). Review † † Most blood cells are formed in bone marrow. Blood (hematopoietic) stem cells are the cells from which all blood cells are formed. † † MPNs are a group of rare blood cancers. CML is a type of MPN. It affects blood stem cells that make granulocytes. † † There are 3 phases of CML. The chronic phase is the first phase. The accelerated phase is the second phase. The third and final phase is called the blast phase.