Stages of Leukemia

[Guest guest]

I found this article by Dr. Kantajarian of MDACC about the different stages of

CML. I am posting this for newcomers.

http://www.caring4cancer.com/go/cml/basics/staging-of-chronic-myeloid-leukemia.h\

tm

To understand the best treatment options available to you for chronic myeloid

leukemia (CML), it is important for you and your doctor to know the phase

(stage) that the disease has reached.

Chronic phase - Patients in the chronic phase have stable disease with only

minor symptoms. There is no cancer outside the bone marrow, blood, or spleen.

White blood cell and platelet blood counts are easily controlled by a

drug—called Gleevec® (imatinib mesylate)—that targets the Philadelphia

abnormality.

Accelerated phase - When chronic myeloid leukemia becomes difficult to control

with imatinib, the white blood count begins to increase. New symptoms may appear

and old symptoms may worsen. The spleen may enlarge and/or new abnormal

chromosomes can be detected in the bone marrow cells. Eventually, the leukemia

becomes completely resistant to treatment. The bone marrow becomes overburdened

with large numbers of immature white blood cells known as " blasts. " A diagnosis

of accelerated phase requires at least one of the following:

a.. The persistent presence of 10 percent to 30 percent myeloblasts in the

bone marrow or peripheral blood

b.. A major increase of the white blood cell count to more than 50,000,

platelet counts that are increased or decreased, and red blood cell levels that

are low despite treatment

c.. Progressive enlargement of the spleen

d.. Growth of leukemia outside the bone marrow or spleen

e.. The presence of any genetic abnormality in addition to a Philadelphia

chromosome

f.. Persistent unexplained fever or bone pain

Blastic phase - Your disease is considered to be in blastic phase if you have 30

percent or more blasts in your marrow or blood.

__________________________________________

If you have been recently diagnosed with chronic myeloid leukemia (CML), you

probably have many thoughts running through your head and you may feel unable to

think clearly. However, it is important for you to ask questions about any

concerns you have and to ask for definitions of words you don't understand. Be

sure to take a pen and pad with you, as you probably won't remember all the

answers. If the doctor uses words you don't understand, ask for an explanation.

You have the right to have your concerns answered. If your doctor does not have

time to give you all the information you need, the nursing staff in his office

may be able to answer your questions. You may also want to ask if there is any

patient literature available.

If possible, bring a spouse, friend, or relative with you. They can take notes

from your conversation with the doctor. You may even want to tape record your

discussion so you can replay the answers to your questions at a later time. Of

course, you must first ask your doctor's permission to do this.

Here is a list of questions you may want to ask. These are only suggestions; you

should feel free to replace any or all with questions of your own.

a.. What type of leukemia do I have?

b.. How far advanced is my leukemia? Is it in chronic, accelerated, or blastic

phase? What is this based on?

c.. Did you document the Philadelphia chromosome abnormality? Are there other

chromosome abnormalities?

d.. Do you know how quickly it is likely to progress?

e.. Can I enroll in a clinical trial? How would this affect the quality of my

treatment?

f.. What is the recommended treatment for my stage of leukemia?

g.. If I don't have insurance coverage, what are my options?

h.. Which center would be able to provide the best treatment for my leukemia?

i.. I am afraid to have a bone marrow transplant. Are there any other options?

j.. When should I start treatment?

k.. If I have this treatment, what are my chances of survival?

l.. If I have treatment, will my leukemia return? If the leukemia comes back,

can it be treated successfully again?

m.. What other tests are you recommending?

n.. What extra information do you get from each of these tests?

o.. How soon I do get the results of these tests?

p.. Could you please describe what each of these tests involves and tell me

how to prepare for them?

q.. Are there any lifestyle changes I can make to improve my prognosis?

r.. Why do I need more treatment after I achieve remission?

s.. Can I pass it on to my children?

This and more can be found at the above website.

Blessings and peace of mind,

Lottie

[Guest guest]

Lottie,

Ty I saved this so i can print it out and take to DR. Mine doesn't

think a BMB is even necessary..I want to provide him with info as to

why it is needed.

Thanks

SharonS

In , " Lottie Duthu " <lotajam@...> wrote:

>

> I found this article by Dr. Kantajarian of MDACC about the

different stages of CML. I am posting this for newcomers.

> http://www.caring4cancer.com/go/cml/basics/staging-of-chronic-

myeloid-leukemia.htm

> To understand the best treatment options available to you for

chronic myeloid leukemia (CML), it is important for you and your

doctor to know the phase (stage) that the disease has reached.

> Chronic phase - Patients in the chronic phase have stable disease

with only minor symptoms. There is no cancer outside the bone marrow,

blood, or spleen. White blood cell and platelet blood counts are

easily controlled by a drug—called Gleevec® (imatinib mesylate)—that

targets the Philadelphia abnormality.

>

> Accelerated phase - When chronic myeloid leukemia becomes difficult

to control with imatinib, the white blood count begins to increase.

New symptoms may appear and old symptoms may worsen. The spleen may

enlarge and/or new abnormal chromosomes can be detected in the bone

marrow cells. Eventually, the leukemia becomes completely resistant

to treatment. The bone marrow becomes overburdened with large numbers

of immature white blood cells known as " blasts. " A diagnosis of

accelerated phase requires at least one of the following:

>

>

> a.. The persistent presence of 10 percent to 30 percent

myeloblasts in the bone marrow or peripheral blood

> b.. A major increase of the white blood cell count to more than

50,000, platelet counts that are increased or decreased, and red

blood cell levels that are low despite treatment

> c.. Progressive enlargement of the spleen

> d.. Growth of leukemia outside the bone marrow or spleen

> e.. The presence of any genetic abnormality in addition to a

Philadelphia chromosome

> f.. Persistent unexplained fever or bone pain

> Blastic phase - Your disease is considered to be in blastic phase

if you have 30 percent or more blasts in your marrow or blood.

> __________________________________________

> If you have been recently diagnosed with chronic myeloid leukemia

(CML), you probably have many thoughts running through your head and

you may feel unable to think clearly. However, it is important for

you to ask questions about any concerns you have and to ask for

definitions of words you don't understand. Be sure to take a pen and

pad with you, as you probably won't remember all the answers. If the

doctor uses words you don't understand, ask for an explanation.

>

> You have the right to have your concerns answered. If your doctor

does not have time to give you all the information you need, the

nursing staff in his office may be able to answer your questions. You

may also want to ask if there is any patient literature available.

>

> If possible, bring a spouse, friend, or relative with you. They can

take notes from your conversation with the doctor. You may even want

to tape record your discussion so you can replay the answers to your

questions at a later time. Of course, you must first ask your

doctor's permission to do this.

>

> Here is a list of questions you may want to ask. These are only

suggestions; you should feel free to replace any or all with

questions of your own.

>

>

> a.. What type of leukemia do I have?

> b.. How far advanced is my leukemia? Is it in chronic,

accelerated, or blastic phase? What is this based on?

> c.. Did you document the Philadelphia chromosome abnormality? Are

there other chromosome abnormalities?

> d.. Do you know how quickly it is likely to progress?

> e.. Can I enroll in a clinical trial? How would this affect the

quality of my treatment?

> f.. What is the recommended treatment for my stage of leukemia?

> g.. If I don't have insurance coverage, what are my options?

> h.. Which center would be able to provide the best treatment for

my leukemia?

> i.. I am afraid to have a bone marrow transplant. Are there any

other options?

> j.. When should I start treatment?

> k.. If I have this treatment, what are my chances of survival?

> l.. If I have treatment, will my leukemia return? If the leukemia

comes back, can it be treated successfully again?

> m.. What other tests are you recommending?

> n.. What extra information do you get from each of these tests?

> o.. How soon I do get the results of these tests?

> p.. Could you please describe what each of these tests involves

and tell me how to prepare for them?

> q.. Are there any lifestyle changes I can make to improve my

prognosis?

> r.. Why do I need more treatment after I achieve remission?

> s.. Can I pass it on to my children?

> This and more can be found at the above website.

> Blessings and peace of mind,

> Lottie

>

>

>