Chronic myeloid leukemia (CML) is a blood cancer that results from a genetic abnormality that causes the production of too many white blood cells in the bone marrow. However, CML is not a genetic disease that runs in families; instead, it is caused by a change in the person’s genetic makeup for reasons that are not fully understood.
The majority of patients with CML have some genetic alternation that causes this abnormality. The National Cancer Institute estimated that 52,380 cases of CML occurred in 2014.
The New CML Drugs
In the past decade, several new drugs, called tyrosine kinase inhibitors (TKIs), have changed the face of CML from a life sentence to a chronic disease. Patients can now live long lives, as long as they continue to take their medication and don’t develop any resistance to it. The majority of TKIs are available as a pill or a capsule taken by mouth, and others are administered as an injection.
The TKIs have to be used in a specific order, with some being tried first before the doctor can prescribe a different TKI. In other cases, a patient may have side effects from one of these drugs, and the doctor will have to prescribe a different one. Each of these drugs also has different side effects. Ask your doctor to explain which of these TKIs is best for you, and why.
These new drugs are saving patients’ lives, but they are not cheap. The cost of each TKI is different, and every insurance company covers a different portion of the drug cost. Many drug companies now offer patients help with the cost of their cancer medications. Ask your care navigator to find out how much you will have to pay for the medication that is best for you, and if you need help with payments, don’t hesitate to tell your navigator.
The Symptoms of CML
CML has 3 types, or phases, called “chronic phase,” “accelerated phase,” and “blast crisis phase.” Each type of CML develops at a different pace and has different symptoms:
- In chronic-phase CML, patients often don’t have symptoms initially, and the disease progresses slowly.
- In accelerated-phase CML, the disease progresses more rapidly; its symptoms include extreme tiredness, fever, bruises, night sweats, shortness of breath, loss of appetite, unexplained weight loss, feeling of fullness/pain below the ribs on the left side, and bone pain.
- In the blast crisis phase, the disease progresses very fast and requires urgent treatment; its symptoms include infections, bleeding, skin changes (including bumps/tumors), swollen glands, and bone pain.