What do Doctors call this Condition?

Doctors also call this condition chronic myelogenous leukemia and chronic myelocytic leukemia.

What is this Condition?

In chronic granulocytic leukemia (CGL), precursors to certain white blood cells called granulocytes multiply abnormally in the bone marrow, blood, and body tissues. It is most common in young and middle-aged adults (rare in children) and is slightly more common in men than women. In the United States, CGL accounts for roughly 20% of all diagnosed cases of leukemia.

There are two distinct phases of the disease: an insidious chronic phase, with anemia and bleeding abnormalities, and an acute phase (blastic crisis), in which myeloblasts (the most primitive granulocytic precursors) multiply rapidly. No cure exists for this disease - at least not yet.

What Causes it?

Experts believe that this disease is caused by an unidentified virus. It is notable that most people with CGL have a chromosomal abnormality called the Philadelphia chromosome, which may be caused by radiation and carcinogenic chemicals.

What are its Symptoms?

Typical symptoms include:

  • anemia (marked by fatigue, weakness, decreased exercise tolerance, pallor, shortness of breath, rapid heart rate, and headache)
  • a low platelet count, with resulting bleeding and clotting disorders such as retinal hemorrhage, blood in the urine, black tarry stools, bleeding gums, nosebleeds, and easy bruising
  • an enlarged liver and spleen, with abdominal discomfort and pain.

Other common symptoms include tenderness in the ribs and sternum, low-grade fever, weight loss, loss of appetite, gouty arthritis, occasional prolonged infection and ankle swelling and, rarely, prolonged or constant erection of the penis.

How is it Diagnosed?

Lab tests, including chromosomal analysis, confirm a diagnosis of CGL. Blood tests usually reveal changes in white blood cells and other abnormalities. A test called bone marrow aspiration shows the effect of the disorder on bone cells. A computed tomography scan (commonly called a CAT scan) may identifY the organs affected by leukemia.

How is it Treated?

Even with chemotherapy, doctors have had little success in producing remissions in people with CGL. The goal of treatment during the chronic phase is to control the proliferation of white blood cells and platelets by giving drugs. The most commonly used oral drugs are busulfan and hydroxyurea. Aspirin is commonly given to prevent stroke if the person’s platelet count is especially high.

Other potentially helpful treatments include:

  • radiation therapy of the spleen or removal of the spleen to increase the platelet count and limit the complications of spleen enlargement
  • leukapheresis (selective leukocyte removal) to reduce the white blood cell count
  • allopurinol, a drug that helps prevent excess uric acid in the blood, or colchicine, a drug that relieves gout caused by elevated uric acid levels
  • prompt treatment of infections (chemotherapy may cause bone marrow suppression, which can lead to infection).

During the acute phase of CGL, lymphoblastic or myeloblastic leukemia may develop. Treatment is similar to that for acute lymphoblastic leukemia. A bone marrow transplant may produce long periods without symptoms in the early phase of illness but has been less successful in the acute phase.