Chronic Myelogenous Leukemia (CML)

Expert Care and Treatment for Leukemia and Related Disorders

Dana-Farber Brigham Cancer Center’s Adult Leukemia Program within the Hematologic Oncology Treatment Center includes hematologists, medical oncologists, pathologists, and radiation therapists who specialize in treating patients with all types of leukemia and related blood and bone marrow disorders.

Your care team will collaborate to develop a comprehensive, personalized treatment plan that offers the most advanced therapies and an array of supportive resources.

Adult Leukemia Program

What Is Chronic Myelogenous Leukemia?

Chronic myelogenous leukemia (CML), also known as chronic myeloid leukemia, is a type of bone marrow cancer in which the bone marrow produces too many mature white blood cells. CML is most often a slowly progressing disease that is chronic (long-term).  

People with CML have acquired an abnormality that causes a short chromosome, called the Philadelphia chromosome. This leads to the development of an abnormal gene BCR-ABL, which acts as a switch that is stuck in the “on” position to stimulate a type of white blood cells called granulocytes to grow out of control. These can build up in the blood and bone marrow so there is less room for healthy white blood cells, red blood cells, and platelets. The overgrowth of white blood cells increases the size of the spleen. 


CML accounts for 15 percent of all leukemias in adults. About 8,000 new cases are diagnosed each year in the United States. About half of patients diagnosed are 65 years old or older. 

Risk Factors 

Risk factors include: 

  • Being exposed to high-dose radiation 
  • Age — the risk of developing CML increases with age 
  • Being male 

Symptoms and Signs 

Because CML progresses relatively slowly, people may not have any symptoms in its early stages. Sometimes CML does not cause any symptoms at all. 

The most common signs of CML include: 

  • Fever 
  • Unexplained weight or appetite loss 
  • Weakness or fatigue 
  • Shortness of breath 
  • Easy bruising 
  • Night sweats 
  • Pain or fullness below the ribs on the left side 

Growth and Outlook 

CML is classified into phases that help predict a patient's prognosis. The phases are based mainly on the number of immature white blood cells — myeloblasts (or blasts) — that are seen in the blood or bone marrow. 

CML: Three Phases 

The disease has three general phases: chronic phase, accelerated phase, and blastic phase. Most patients are diagnosed in the chronic phase. As the amount of blast cells increases in the blood and bone marrow, there is less room for healthy white blood cells, red blood cells, and platelets. This may result in infections, anemia, and easy bleeding, as well as bone pain. The number of blast cells in the blood and bone marrow and the severity of signs or symptoms determine the phase of the disease. 

  • In the chronic phase, fewer than 10 percent of the cells in the blood and bone marrow are blast cells. 
  • In the accelerated phase, 10 to 19 percent of the cells in the blood and bone marrow are blast cells. 
  • In the blastic phase, 20 percent or more of the cells in the blood or bone marrow are blast cells. When tiredness, fever, and an enlarged spleen occur during the blastic phase, it is called blast crisis. 

Other Factors 

Along with the phase, other factors — such as a person's age, spleen size, and/or blood counts — may help predict the outlook and can sometimes inform the treatment plan. We take these factors into account using the Sokal and Hasford prognostic scoring systems. 

Why Choose Us

When choosing the right treatment center to treat or monitor your leukemia, you want to know you will be in highly skilled and compassionate hands. The Adult Leukemia Program team at Dana-Farber Brigham Cancer Center has extensive experience caring for patients with CML and are world leaders in advancing the treatment of leukemia. 

Our program offers you access to an experienced team of specialists who concentrate exclusively on patients with leukemia; many of our specialists are recognized as national leaders in their field. The program is part of the Hematologic Oncology Treatment Center, which includes the hematopoietic Stem Cell Transplantation Program — one of the world's largest and most experienced stem cell transplant centers. 

We provide comprehensive services to patients with these cancers, including:  

  • Personalized treatment plans, ranging from standard supportive care to intensive chemotherapy for chronic leukemia 
  • Access to new therapies through clinical trials, some of which may not be available elsewhere 
  • Close collaboration with the experts in our Bone Marrow Transplantation Program at Dana-Farber Brigham Cancer Center, one of the largest and most experienced programs in the world 
  • Access to the latest diagnostics, such as molecular and genomic profiling, including the Rapid Heme Panel
  • Multidisciplinary care delivered by specialists from Dana-Farber Cancer Institute and Brigham and Women’s Hospital