Chronic Myeloid Leukemia

• Chronic myeloid leukemia (CML)—also known as chronic granulocytic, chronic myelocytic or chronic myelogenous leukemia—is a rare type of blood cancer that typically grows worse slowly.
  
• Unlike other cancers, chronic myeloid leukemia originates from the presence of a genetic abnormality in blood cells called the Philadelphia chromosome and progresses through distinct phases.
  
• In a healthy person, bone marrow makes the blood stem cells that mature into infection-fighting white blood cells, oxygen-carrying red blood cells and blood-clotting platelets. When a person has CML, too many blood stem cells develop into a type of white blood cell called granulocytes, which are abnormal and never become healthy white blood cells.
  
• In the first stages of CML, known as the chronic phase, patients show few signs of illness. In the end, however, millions of abnormal, useless white blood cells accumulate, preventing production of normal blood cells and blood-clotting platelets. Patients suffer from infections, anemia, uncontrolled bleeding and other complications that lead to death.
  
• CML usually occurs during or after middle age and rarely develops in children. Bone-marrow or stem-cell transplantation is the only known cure for the disease.

Detecting and monitoring CML – Dr. Jerry Radich, Hutchinson Center colleagues and an international research group developed a molecular test that is sensitive enough to detect one blood cancer cell among a million normal cells. Used to monitor the disease status of CML patients after treatment with a bone marrow or stem cell transplant, this test enables doctors to respond quickly at the first sign of relapse. Studies are ongoing to develop even more sensitive assays for rare CML cells. The hope is that such a sensitive test might be able to determine which patients on therapy can actually discontinue medication without fear of relapse. Learn more »

Bone marrow transplant – Led by Nobel Prize recipient Dr. E. Donnall Thomas, Hutchinson Cancer researchers have transformed bone marrow transplantation into standard treatment for CML and other blood cancers. The procedure, as well as its sister treatment stem cell transplantation, is widely recognized as one of the greatest achievements in cancer treatment. Hundreds of thousands of lives have been saved thanks to bone marrow transplantation. Learn more »

Developing and improving drug treatments – The Hutchinson Center has participated in clinical trials that led to the FDA approval of the "leukemia pill," Gleevec® (also known as STI-571). As doctors obtain greater experience using the drug, they have observed that some patients fail to respond to the drug, while others relapse.

Center investigators continue to study the long-term effectiveness of Gleevec to determine which CML patients are best treated with the drug and which other treatments may work effectively in conjunction with the drug. In addition, the Center contributed to the FDA approval of "second generation" tyrosine kinase inhibitors known as nilotinib and dasatinib. Center investigators are now involved in bench and clinical studies of other new agents for CML patients who fail to respond to first and second line agents.

Immunotherapy –  Dr. Stanley Riddell and colleagues have been investigating use of a treatment technique for leukemia called immunotherapy—harnessing the body's own infection-fighting T-cells against the disease. The approach holds promise for treating several types of cancer, including chemotherapy-resistant ALL in children. Learn more »

Post-transplant survival - Our research has shown that CML patients who received a bone marrow transplant from an unrelated donor with matching tissue could expect about the same five-year survival rate as patients with matched related donors. Since then, our researchers have led the way in improving the treatment of CML.

Mental function – Research by Dr. Karen Syrjala shows that the decline in mental skills experienced by many bone marrow and stem cell transplant patients is largely temporary. Patients who experience these symptoms can expect a return to normal cognitive functions with a year of their transplant, according to Syrjala’s 2004 study. More recent research shows that mental conditions continue to improve after one year. Learn more »

10-year health – A study by Dr. Syrjala shows that after 10 years survivors of stem cell transplants for blood cancers are nearly as healthy as people who didn’t undergo the procedure. Both populations had similar rates of asthma, diabetes, high blood pressure, high cholesterol and osteoporosis. In addition, they also had similar psychological health, marital satisfaction and employment. Learn more »