The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Chronic Myeloid Leukaemia (CML)

Philadelphia-chromosome leukaemia with long-term remission under TKI therapy.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Hematoloji department. Book Appointment →

What is Chronic Myeloid Leukaemia (CML)?

Chronic myeloid leukaemia (CML) is a myeloid stem-cell disease driven by the BCR–ABL1 fusion gene produced by the Philadelphia chromosome — a balanced t(9;22)(q34;q11) translocation. The BCR–ABL1 tyrosine kinase drives uncontrolled proliferation of myeloid progenitors.

CML progresses in three phases: chronic phase (most common at diagnosis and highly responsive), accelerated phase, and blast crisis (aggressive leukaemic transformation). Tyrosine kinase inhibitors (TKIs) achieve deep molecular responses in over 80% of chronic-phase patients, and many now reach normal life expectancy.

Imatinib revolutionised CML treatment as the first TKI. Second-generation agents (dasatinib, nilotinib, bosutinib) and third-generation agents (ponatinib, asciminib) provide effective options for resistance or intolerance. Treatment-free remission (TFR) is an active area of investigation in patients with deep molecular response.

Symptoms

Most patients present with incidental leukocytosis on routine blood tests
Fatigue and malaise
Left-upper-quadrant pain and early satiety from splenomegaly
Weight loss and night sweats
Gouty arthritis from hyperuricaemia
Blast crisis: fever, severe infection, bone pain

Risk Factors

Ionising radiation exposure (Hiroshima/Nagasaki data)
Age (mean 50–60 years)
Male sex (slight predominance)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Refer to haematology for leukocytosis, especially granulocytosis
  • Splenomegaly with fatigue and weight loss
  • CML diagnosis requires haematology planning before initiating TKI
  • Regular BCR–ABL1 PCR monitoring during TKI therapy

Treatment Methods

01
First-line TKI: imatinib 400 mg/day or dasatinib, nilotinib or bosutinib for faster response
02
Resistance/intolerance: second-generation TKI or ponatinib / asciminib for T315I mutation
03
Blast crisis: intensive chemotherapy with TKI and allogeneic stem cell transplant
04
Treatment-free remission (TFR): discontinuation trials after sustained deep molecular response
05
Pregnancy: TKIs are foetotoxic, so individualised planning is required

Which Department to Visit?

You can visit our Hematoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Hematoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Anaemia

Dahiliye (İç Hastalıkları)

Anaemia is a low haemoglobin level that reduces oxygen delivery, causing fatigue, pallor, and shortness of breath. It is not a disease itself but a sign of many underlying conditions. Most cases are correctable with appropriate diagnosis and treatment.

Iron Deficiency Anaemia

Dahiliye (İç Hastalıkları)

Iron deficiency anaemia develops when dietary intake, absorption, or losses create an iron shortfall, most often affecting women and children. Identifying the underlying cause is the core of management, alongside iron replacement.

Vitamin B12 Deficiency

Dahiliye (İç Hastalıkları)

Vitamin B12 deficiency can cause megaloblastic anaemia, neurological symptoms, and cognitive impairment. Early treatment with intramuscular or oral B12 largely prevents irreversible complications.

Hypertension (High Blood Pressure) Management

Dahiliye (İç Hastalıkları)

Hypertension is often called the silent killer because it progresses symptom-free for years and can damage the heart, brain, kidneys, and eyes. Regular monitoring, lifestyle change, and evidence-based drug therapy dramatically reduce cardiovascular risk.

Chronic Kidney Disease

Dahiliye (İç Hastalıkları)

Chronic kidney disease is one of the most common complications of chronic conditions such as diabetes and hypertension, and can be silent in its early stages.

Hepatitis B (HBV)

Dahiliye (İç Hastalıkları)

Hepatitis B is a DNA virus infection causing acute and chronic hepatitis with risk of cirrhosis and hepatocellular carcinoma; diagnosis integrates HBsAg, HBeAg, anti-HBc, and HBV DNA with management based on disease phase using nucleos(t)ide analogues (entecavir, tenofovir) and universal infant vaccination.

Hepatitis C (HCV)

Dahiliye (İç Hastalıkları)

Hepatitis C is an RNA virus causing chronic hepatitis that may progress to cirrhosis and hepatocellular carcinoma; modern direct-acting antiviral (DAA) pangenotypic regimens (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir) achieve sustained virologic response over 95% in 8–12 weeks with universal adult screening and cure for nearly all patients.

Fatty Liver Disease

Dahiliye (İç Hastalıkları)

Non-alcoholic fatty liver disease (NAFLD) is closely related to obesity and metabolic syndrome and is largely reversible with early treatment.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.