What is Chronic Myeloid Leukaemia (CML)?
The World Health Organization (WHO) classifies chronic myeloid leukaemia (CML) as a myeloproliferative disease characterised by the presence of the Philadelphia chromosome (Ph) or the BCR-ABL fusion oncogene1. The diagnosis is generally easily made on the basis of morphological examination of a peripheral blood smear, but confirming genetic studies have become essential with the advent of molecularly targeted therapy.
Leukaemias account for 300,000 new cases (~3% of all new cancer cases) each year and 220,000 deaths worldwide2. CML accounts for about 15%-20% of all adult leukaemias and occurs slightly more frequently in men than in women (incidence ratio: 1.4 to 2.2:1)3-6.
Phases of CML
Chronic myeloid leukemia typically progresses through 3 stages or phases. Most patients present in chronic phase, deteriorate during the subsequent accelerated phase, and finally progress to a brief terminal phase, blast crisis. Although the lengths of the phases were altered by previous therapies, the clinical course and natural history of CML had not been changed before the molecular era.
Treatment for CML
Within the treatment section we examine the following treatment options:
Advances in the investigation of the molecular biology of cancer over several decades have made it possible to rationally design drugs to target oncogenic events with unprecedented specificity7
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7. Druker BJ. Perspectives on the development of a molecularly targeted agent. Cancer Cell. 2002;1:31-36.