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Chronic myeloid leukemia, also called chronic myelogenous leukemia and CML, is a form of leukemia (blood cancer) that develops in the bone marrow, the soft, spongy center of long bones. CML is a cancer of a subtype of white blood cells called a "myeloblast."
Normal myoblasts grow, divide, and mature into white blood cells capable of fighting infections. This process is controlled by the body through complex signaling networks. In a patient with CML, the bone marrow makes abnormal myeloblasts that don't
respond to these normal signals and as a result produce large amounts of abnormal white blood cells in an uncontrolled manner. These abnormal cells do not fight infections, but spill into the blood in large numbers, causing a variety of serious problems.
CML is very rare in children. Approximately 150 children in the U.S. are diagnosed with CML each year. Children and teens with chronic myeloid leukemia are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through the Childhood Leukemia Program.
Dana-Farber/Boston Children's offers a wide array of support services and programs for pediatric patients and their families during and after cancer treatment.
Chronic myeloid leukemia (CML) can be divided into three distinct phases, or stages of development:
The symptoms of CML are related to the phase of the disease and often vary from child to child. Patients with chronic phase CML sometimes have no symptoms of the disease and CML may be discovered when your child is having a routine blood test for other
reasons. Patients in the accelerated phase or blast crisis often have symptoms related to abnormal bone marrow function.
The most common symptoms of childhood CML include:
These are general symptoms of the disease, but do not include all possible symptoms. It's important to have your child evaluated by a qualified medical professional right away for an accurate diagnosis and prompt treatment.
It is not known what causes leukemia, including CML. In the majority of childhood leukemias, gene mutations and chromosome abnormalities in the leukemia cells occur by chance. The abnormalities found in leukemia cells are not found in the other cells
of the body.
Nearly all cases of CML are associated with a specific type of genetic abnormality called a chromosomal translocation. In this translocation, part of chromosome #9 breaks off and attaches itself to part of chromosome #22. The resulting abnormal chromosome,
often called the "Philadelphia chromosome," forms an abnormal gene called BCR-ABL. This gene makes an abnormal protein which drives the development of the abnormal myeloblasts.
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