The phase of your chronic myeloid leukemia (CML) plays a large part in determining the type of treatment you'll receive. CML has three phases:
Each phase describes CML's progression, determined by the number of blast cells (white cells that don't fully form as they should, blocking production of functioning blood cells) in the blood and bone marrow.
Most patients are diagnosed during CML's chronic phase when symptoms are mild or not noticeable.
- During this phase, your white cells can still fight infection.
- In most cases, long-term drug therapy can control chronic phase CML, and you can usually return to normal activities after treatment begins.
A small number of people diagnosed and treated during the chronic phase progress to the accelerated phase. These patients appear to stop responding to treatment as the disease advances.
If you're diagnosed during accelerated phase CML, you may have:
- A lower-than-normal number of red cells
- A low number of platelets
- An increase or decrease in white cells
- A high number of blast cells in the blood and bone marrow
- A swollen spleen, which can cause stomach discomfort
- A general feeling of ill health
If you're diagnosed in CML's blast crisis phase, you:
- Have an increased number of blast cells in your bone marrow and blood.
- Generally also have lower-than-normal numbers of red cells and platelets.
In this phase you may experience:
- A lack of energy or feelings of tiredness
- Shortness of breath
- Stomach pain (from an enlarged spleen)
- Bone pain
Once CML reaches this more severe, advanced phase, its effects on patients are similar to those caused by an acute leukemia and can be life-threatening. In about 25 percent of people, the transformation in the blast crisis takes on the appearance of acute lymphoblastic leukemia, while in the majority it takes on the appearance of acute myeloid leukemia.