Coping with Accelerated Phase

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Feeling Sick With CML: Coping With Accelerated and Blast Crisis Phase

WebMD Feature

By Annie Stuart, Reviewed By Brunilda Nazario, MD

If you were diagnosed during the chronic phase of chronic myelogenous leukemia

(CML), you may have felt fine most of the time and lived a fairly normal life.

But if you've entered the CML accelerated or blast phase, things have likely

changed. You may feel sick and weak and have a wide range of symptoms.

To cope with CML now, it well help to work even more closely with your doctors

and to better understand what's going on inside your body.

When the CML Chronic Phase Ends

Chronic myelogenous leukemia is a disease of the bone marrow. As you may know,

CML tends to get worse more slowly than other types of leukemia.

" During the CML chronic phase, your blood cell-making program simply shifts into

high gear and pumps out more of the normal spectrum of blood cells, " says Jerald

P. Radich, MD, medical director of the Research Trials Office and Molecular

Oncology Lab at Fred Hutchinson Cancer Research Center/Seattle Cancer Care

Alliance. As a result, your white blood count can increase by as much as 10 or

20 times, he says.

Today, medications can be very effective during the CML chronic phase, allowing

many people to live free or nearly free of symptoms for years. These drugs are

often very successful at blocking the protein made by the BCR-ABL cancer gene.

It is this Philadelphia chromosome that basically drives everything at this

stage of CML, Radich says.

But perhaps your CML was caught late or you were unable to take medications.

Maybe your disease became resistant to medication, or treatment stopped working

for a reason that is not yet well understood.

As you enter the CML accelerated or blast phase, other changes begin to occur as

well. The Philadelphia chromosome no longer drives your disease alone, Radich

says. " You've accumulated a number of other genetic abnormalities besides

BCR-ABL, " he says. These have also moved into the driver's seat. Now, abnormal

cells begin to crowd out normal blood cells and platelets, which are involved

with blood clotting. Coping with CML now becomes a new kind of experience.

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FYI,

Lottie Duthu