Chronic Myelogenous Leukemia (CML) in Children

Chronic Myelogenous Leukemia (CML) in Children

About Leukemia

Leukemia is a type of cancer that affects the body’s leukocyte (WBCs).

Generally, WBCs assist battle infection and secure the body against disease. But in leukemia, WBCs turn malignant and increase when they shouldn’t. This causes a lot of unusual WBCs, which then disrupt the body’s capability to operate usually.

If a lot of these WBCs are made, a child will develop chronic myelogenous leukemia (CML). While this kind of leukemia is far more typical in grownups, it can impact children, too.

Thanks to advances in therapy and clinical trials, the outlook for kids with CML is appealing.

In chronic myelogenous leukemia (CML), the white blood cells that are impacted are a specific kind called myeloid cells, or “myeloblasts.”


CML is triggered by a chromosomal issue. The 23 pairs of chromosomes in the body each consist of sections of DNA called genes. Genes are essentially the body’s plans.

CML occurs when a piece of chromosome 22 breaks off and switches places with a piece of chromosome 9. (This piece, containing parts of both chromosome 9 and chromosome 22, is known as the Philadelphia chromosome.) The mix results in the cancer gene known as BCR-ABL. This is the gene that advises the body to make a lot of unusual WBCs.

Although researchers understand which genes are involved in the development of CML, they do not yet know why some individuals get it and others do not.

Symptoms and signs

CML tends to progress slowly, so in the beginning a child may have couple of or no symptoms. In fact, symptoms can take months and even years to develop. The symptoms of all types of leukemia are generally the very same and include:

  • fatigue and weakness
  • swollen lymph nodes
  • reoccurring infections (like bronchitis or tonsillitis)
  • fever
  • easy bruising
  • bone and joint pain
  • abdominal pain (triggered by unusual blood cells developing in organs like the kidneys, liver, and spleen)

Medical diagnosis

Frequently no symptoms stand for quite a while with CML, so it’s commonly discovered when a child has a routine blood test for other reasons. A doctor who suspects a child has leukemia might buy these tests:

  • Blood tests. Tests such as a total blood count, liver and kidney function panels, and blood chemistries can give important information about the variety of regular blood cells in the body and how well the organs are working. The blood cells will also be examined under a microscope to check for abnormal shapes or sizes.
  • Bone marrow aspiration and biopsy. In this procedure, the doctor inserts a needle into a big bone, generally the hip, and eliminates a small amount of bone marrow to analyze it for abnormal cells.
  • Imaging research studies. These might consist of an X-ray, CT scan, MRI, or ultrasound to check for an enlarged spleen or liver, and also to rule out any other possible causes of a child’s symptoms.
  • Lumbar leak. Likewise called a spinal tap, this procedure uses a hollow needle to eliminate a percentage of cerebrospinal fluid (CSF, the fluid surrounding the brain and spine) for assessment in a laboratory. Malignant WBCs can gather around the brain and spinal cord.
  • Circulation cytometry tests. By studying the leukemia cells gathered from the blood, bone marrow, and/or spinal fluid, medical professionals can determine the kind of leukemia a child has. This is necessary since treatment differs amongst various types of leukemia.
  • Chromosomal tests. By evaluating DNA from a child’s blood or bone marrow, physicians can tell whether the Philadelphia chromosome exists. They likewise can tell the number of cancer cells are in the blood at any given time.
  • Tissue typing or HLA (human leukocyte antigen) typing. If a child needs a stem cell transplant (likewise called a bone marrow transplant), this test assists doctors find a suitable stem cell donor. It works by comparing the proteins on the surface area of a child’s blood cells with the proteins on a potential donor’s cells. The more “HLA markers” a child and donor share, the higher the possibility that a transplant will be successful.

Chronic Myelogenous Leukemia (CML) in Children


Treatment of CML takes into account things like the phase of the leukemia (whether it remains in the early or later stages of the disease), the number of malignant cells in the body, and how well the other organs of the body are working. This info, in addition to a child’s age and overall heath, helps physicians establish treatment strategies that might include these alternatives:

  • Targeted therapy. This treatment uses drugs to determine and attack the cancer cells without hurting the regular cells. These drugs, called tyrosine kinase inhibitors, target the cancer cells in CML and may be used as the first treatment for patients with an early phase CML.
  • Chemotherapy. This is the use of unique drugs to eliminate cancer cells. Often drugs are used in mix to attack the cells in different methods.
  • Stem cell transplant. This procedure (likewise called a bone marrow transplant) includes ruining cancer cells and typical bone marrow and body immune system cells with high-dose chemotherapy then reintroducing healthy donor stem cells into the body. The new stem cells can rebuild a healthy blood supply and immune system.

After treatment starts, the goal is remission (when there is no longer evidence of cancer cells in the body). Once remission happens, maintenance chemotherapy is typically provided to keep a child in remission and to keep eliminating cancer cells. The impact of treatment is examined regularly by determining the number of BCR-ABL remain in the blood using tests called peripheral blood FISH or PCR.


Being informed that a child has cancer can be a terrifying experience, and the stress of cancer treatment can be frustrating for any household.

Although you may seem like it at times, you’re not alone. To find support for you and your child, talk to your doctor or a hospital social employee. Numerous resources are readily available that can assist you make it through this difficult time.

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