Chronic Myeloid Leukemia Patients Are Not Without Hope

Experts define CML (Chronic Myeloid Leukemia), which stems from a genetic disorder known as the Ph chromosome and is treated with targeted therapy methods, as a type of blood cancer. Although many factors are cited as contributing to its development, the incidence of CML—for which no link has been established with factors other than prolonged exposure to high-dose radiation—is calculated at one per hundred thousand people. While it is estimated that approximately 800 people in Turkey contract the disease annually, experts note that since the early 2000s, with the introduction of new drugs, most CML patients remain in the chronic phase and live the normally expected lifespan. Prof. Dr. Güray Saydam, Head of the Hematology Department at Ege University Faculty of Medicine, who provided information about CML disease within the scope of 22 September "International CML Day," stated that a genetic disorder underlies the disease; this disorder arises in human stem cells when a segment that breaks off from chromosome 9 exchanges places with a segment that breaks off from chromosome 22. Prof. Dr. Saydam noted that authorities working on CML for a long time have symbolized chromosome 9 as the 9th month, namely September, and chromosome 22 as the 22nd day of September, adding that this is why CML-related awareness activities are organized every year on the 22nd of September, which is the 9th month.

Saydam, stating that no patient has come to them saying "I have CML!", said, "In this disease, the spleen becomes so enlarged that it can completely fill the abdominal region, and as a result, there can be symptoms such as abdominal swelling and early satiety.

Additionally, since it is a bone marrow disease, there can be bone pain; since it is a systemic disease, there can be fever, weight loss, fatigue, frequent and recurrent infections, and bleeding in the skin and mucous membranes. It cannot be said that people with one or several of these symptoms definitely have CML. The necessary laboratory tests must be performed," he said. Prof. Dr. Saydam noted that following a complete patient history and physical examination, a complete blood count and peripheral blood smear, bone marrow aspiration and biopsy, and advanced testing methods from the bone marrow sample with special chromosome analysis must be performed. Prof. Dr. Saydam, noting that before the 2000s, every patient diagnosed went through three stages—chronic phase, accelerated phase, and blastic (blood cancer) phase—but that unless allogeneic stem cell transplantation, the only curative treatment method available, could be applied, every patient experienced all three stages and the process unfortunately ended poorly, stated that since the early 2000s, with the introduction of new drugs, most patients have remained in the chronic phase and have been able to live the normally expected lifespan. Prof. Dr. Saydam emphasized that today, worldwide, the first treatment option for a patient diagnosed with CML is drugs called tyrosine kinase inhibitors and that these remain licensed and actively used in the treatment of newly diagnosed patients in many countries, including our country, and that following FDA approval of these targeted drugs in the early 2000s; the course of CML has completely changed, and whereas there was previously an expectation of an average five-year lifespan under normal circumstances, today this period has become equal to that of normal individuals," he said. Saydam noted that in a very small group of patients, allogeneic stem cell transplantation remains an option, saying, "However, special conditions are required for this. In special situations such as pregnancy, different treatment methods can be applied. Apart from this, excluding rare cases where stem cell transplantation could be an alternative, today standard treatment can be provided with drugs we call targeted tyrosine kinase inhibitors," he concluded.