Chronic granulocytic leukemia begins in the same way as acute myelogenous leukemia . A malignant, or life-threatening, change occurs in bone marrow cells that pro­duce granulocytes, a type of white blood cell. As a result, the number of granulocytes in your blood rises excessively, often to between 20 and 40 times the normal level. When the disease is not treated, the multiplication of granulocytes may limit the production of red blood cells, so you may also become anemic. In addition, the accumulation of leukemic cells may cause enlargement of both your spleen and your liver.

What are the symptoms?

If you have chronic granulocytic leukemia, you feel generally ill, have little appetite, and lose weight. You may have a fever and sweat at night. In addition, your enlarged spleen may cause a sense of fullness in the left upper portion of the abdomen. You may also have symptoms of anemia .

What are the risks?

If chronic granulocytic leukemia is not treated, it is likely to be fatal within weeks or months. The disease usually responds very well to initial treatment, which gives most patients at least two to three more years of fairly normal life. Eventually, the disease begins to resemble acute leukemia, and it no longer responds to treatment.

What should be done?

If you have any of the symptoms described, you should see your physician, who will probably examine you and arrange for blood tests. The blood tests will either rule out the disease, or indicate the need to take further blood tests. To establish a clear diagnosis, there may also be a bone marrow biopsy, in which a small sample of marrow is removed to be examined.

What is the treatment?

Most people who have the disease can be treated as out-patients. The basic treatment is tablets of anticancer drugs that usually restore bone marrow production to normal and clear up the symptoms. Some people need to continue to take the medication regularly, while others require it only intermittently. Your physician will watch your condition, and take blood tests every two to four weeks. This is important because the dose of medication often needs to be adjusted, and too much of the drug decreases your blood count to dangerous levels.

After some time, treatment with drugs will no longer control the disease. The average length of time before this occurs is three years, but it can be much shorter or much longer. Eventually the leukemia becomes much worse and you will probably be admitted to a hospital. At this stage of the disease, stronger anticancer drugs may help you for a short time, but often it is only a matter of weeks before the disease proves fatal.