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CML Phases and Prognostic Factors
CML has three phases. The phase of your chronic myeloid leukemia (CML) plays a large part in determining the type of treatment you'll receive. Doctors use diagnostic tests to determine the phase of CML. Determining the CML phase is based primarily on the number of immature white blood cells (blasts) in the patient’s blood and bone marrow.
Phases of CMLChronic Phase. Most patients are diagnosed with CML in the with chronic phase of the disease.
People with chronic phase CML:
Treatment
Parents are advised to
- Seek treatment from a hematologist/oncologist who is experienced in treating JMML, or from a hematologist/oncologist who is in consultation with a cancer center.
- Speak with their child’s doctor about the most appropriate treatment.
Without treatment, JMML progresses rapidly. There are two widely used JMML treatment protocols: stem cell transplantation and drug therapy.
Treatment Outcomes
A few decades ago, there were very low cure rates in both children and adults diagnosed with ALL. Today, childhood ALL has one of the highest cure rates of all childhood cancers, approaching 92 percent for children younger than 15 years and more than 94 percent for children younger than 5 years.
Follow-Up Care
Find more information about follow-up care, including what to expect, long-term and late effects of treatment, survivorship clinics, and other resources, such as The National Comprehensive Cancer Network (NCCN) treatment guidelines.
Treatment Outcomes
In some people with PV, the disease remains stable for many years. In many people, life expectancy is the same as it would be if they did not have PV. With careful medical supervision and therapy, PV can usually be managed effectively for a long time. In some cases, however, it may progress to another type of blood disease, such as myelofibrosis or acute myeloid leukemia.
Jayden
On May 15, 2018, we found out that our baby boy has B-cell leukemia. At first, it was rough but he has now been cleared of any cancer in his body! He still has to undergo chemotherapy for the next two years, but Jayden is a very strong seven year old and he will fight this horrible disease!
Splenectomy
The spleen is an organ on the left side of the body, near the stomach. CLL cells can collect in the spleen, causing it to become enlarged. Sometimes, the spleen becomes so large that it presses on nearby organs, causing pain. Also, an enlarged spleen may lower a person’s blood cell counts to dangerous levels. An operation to remove the spleen is called a splenectomy. Splenectomy is helpful for select patients. The operation may reduce pain and help improve blood counts.
Follow-Up Care
Click here for information about follow-up care, including what to expect, long-term and late effects of treatment, survivorship clinics, and other resources such as The National Comprehensive Cancer Network (NCCN) treatment guidelines.
Use the Survivorship Workbook to collect all the important information you need throughout diagnosis, treatment, follow-up care and long-term management of a blood cancer.
Ph-Positive ALL Therapy
About 25 percent of adults with ALL have a subtype called “Ph-positive ALL” (also known as “Ph+ ALL” or “Philadelphia chromosome-positive ALL”). The leukemia cells of these patients have the Philadelphia chromosome, which is formed by a translocation between parts of chromosomes 9 and 22. A piece of chromosome 9 breaks off and attaches to chromosome 22, and a piece of chromosome 22 similarly breaks off and attaches to chromosome 9. The abnormal chromosome 22 is known as the Philadelphia chromosome. This chromosomal alteration creates a fusion gene called BCR-ABL1.
Relapsed and Refractory
Some chronic myeloid leukemia (CML) patients still have leukemia cells in their bone marrow after initial treatment with a tyrosine kinase inhibitor (TKI). "Refractory" is the term used to refer to a disease that has not responded to the initial treatment. Relapse is the term used to refer to the return of a disease after a period of improvement.
TKIs used for "initial" or first-line treatment for chronic phase CML include:
Dr. Brown
Jennifer Brown, M.D., Ph.D., who played a role in advancing ibrutinib for patients with chronic lymphocytic leukemia (CLL), is the recipient of an LLS Translational Research Program grant, and has previously received a career development program grant.
Her work is currently focused on studying the role that the Notch pathway plays in the development of CLL and whether therapies that target Notch can be effective for these patients.
Follow-Up Care
Click here for information about follow-up care, including what to expect, long-term and late effects of treatment, survivorship clinics, and other resources such as The National Comprehensive Cancer Network (NCCN) treatment guidelines.
Use the Survivorship Workbook to collect all the important information you need throughout diagnosis, treatment, follow-up care and long-term management of a blood cancer.
Payton
My daughter Payton is a two-time cancer survivor. She had acute myeloid leukemia (AML). She had a cord blood transplant on March 8, 2012. She has a dog and a cat, and she loves camping, spending time with her family and playing outside with her friends. She thinks cancer is nasty and she hated it. She is a fighter.
Eryn
I was diagnosed at two years old with acute lymphoblastic leukemia (ALL) and went into remission when I was five. I spent two years at Wilford Hall where I was born.
I'm currently a 15-year-old sophomore in high school and feeling better than ever!
I hope to become a nurse practitioner and specialize in pediatric oncology to help kids who are going through the same thing I went through.
AML Subtypes
Doctors classify acute myeloid leukemia (AML) into subtypes by using various tests. It's important to know your AML subtype because it plays a large part in determining the type of treatment you'll receive.
Signs and Symptoms
Signs and symptoms are changes in the body that may indicate the presence of disease. A sign is a change that the doctor sees during an exam or in a laboratory test result. A symptom is a change that a patient can see and/or feel.
It is common for a child with ALL to feel a loss of well-being because of the lack of normal, healthy blood cells.
Symptoms of a low red blood cell count (anemia) include:
Kate
On May 17, 2018, our family was thrown into the world of blood cancer. Our family's patriarch, our bonus dad, and our beloved "Candy Boy," as he was affectionately nicknamed by his youngest daughter, found out that he was in the aggressive stages of acute myeloid leukemia (AML).
Justin
In March 2012, when Justin was in the sixth grade, he started to rapidly lose weight, was experiencing extreme exhaustion and night sweats. After multiple visits to the doctor but no answers, his parents finally took him to the hospital for more intensive testing, including a bone marrow biopsy. One day later they received the shocking diagnosis: acute lymphoblastic leukemia.
Treatment
It's important that your doctor is experienced in treating patients with acute myeloid leukemia (AML) or has access to an AML specialist.
Types of AML TreatmentDoctors use several types of treatment for adults with AML, some at different stages. Click on the links below to read more about each type of treatment.
Lidia
I am still in treatment for leukemia, a diagnosis my mom was devastated to hear when I was just four years old.
My dream is to meet Roman Reigns and tell my story because his story makes me keep going.
I watch WWE and I even went to a WWE fight. I want to try to going to one next year!
I love seeing Roman and LLS fighting blood cancer!
Addie
Charles Esten, an actor/musician who plays Deacon Claybourne on the TV show “Nashville,” is this year’s Light The Night Walk National Honorary Chair. Esten’s 15-year-old daughter, Addie, was diagnosed with leukemia at age 2 1/2 and, thanks to advances in treatment, is thriving today. Because of their personal connection to blood cancer, Charles, his wife Patty, and the entire Esten clan are strong supporters of LLS.
Jared
At 31, I was diagnosed with acute myeloid leukemia (AML). As my career was finally taking off as a celebrity makeup artist and I finally felt “grown-up,” it came to a screeching halt. My life became cancer and getting better. Although I struggled with the isolation, I connected with many other patients via social media.
Michael
In 1995, Michael’s daughter Carley was diagnosed with acute myeloid leukemia (AML), M-7 – a rare form of blood cancer – at just two and a half years old. For the following year, Michael and his wife, Liz, practically lived at Rady Children’s Hospital in San Diego while Carley underwent heavy chemotherapy treatment.