Category: cancer

Is there a link between button pain and cancer?

Buttock pain can have various causes, including:

  1. Muscle strain or overuse
  2. Sciatica, which is caused by irritation or compression of the sciatic nerve
  3. Piriformis syndrome, where the piriformis muscle in the buttocks irritates the sciatic nerve
  4. Herniated disc in the lower back
  5. Sacroiliac joint dysfunction
  6. Arthritis, such as osteoarthritis or rheumatoid arthritis
  7. Infection, like an abscess or cellulitis
  8. Pelvic conditions, such as endometriosis or pelvic inflammatory disease (PID)

it’s important to note that buttock pain is rarely a direct symptom of primary bone cancer. Primary bone cancer usually presents with localized pain and swelling at the site of the tumor, along with other symptoms like fractures or bone deformities.

Buttock pain can be a symptom of cancer metastases (when cancer spreads to other parts of the body). However, buttock pain alone is unlikely to be the only symptom of metastatic cancer. Other signs typically include weight loss, fatigue, changes in bowel or bladder function, and a general decline in health.

Buttock pain can also be caused by ovarian cancer or prostate cancer, but it is not a specific or definitive symptom of these cancers. Ovarian cancer may present with abdominal or pelvic pain, bloating, and changes in urinary or bowel habits. Prostate cancer may cause symptoms like urinary problems, erectile dysfunction, or bone pain in the hips, back, or pelvis.

If you are experiencing persistent or severe buttock pain, it is recommended to consult a healthcare professional who can evaluate your symptoms, conduct a physical examination, and order relevant tests such as imaging (X-rays, MRI) or blood tests to determine the underlying cause.

what are the survival rates for Chronic myeloid leukemia (CML 0patients?

Chronic myeloid leukemia (CML) is a type of cancer that affects the bone marrow and blood cells. The survival outcomes of this disease are influenced by various factors, such as the phase of the disease, the age and overall health of the individual, and treatment effectiveness. In the United States, individuals with CML have a five-year survival rate of 70.4%[1]. This means that approximately seven out of every ten people diagnosed with CML will survive for at least five years after their diagnosis. However, it is important to note that this survival rate can vary depending on several factors.

what are the factors that contribute to the high survival rate for CML patients treated with imatinib?

The National Cancer Institute reports that almost 65.1% of those diagnosed with CML survive for at least five years after their diagnosis[2]. This indicates that there have been significant advancements in medical treatments for CML over the years. A comprehensive study on CML patients treated with imatinib revealed that about 90% survived five years after commencing therapy[3]. Imatinib is a medication used to treat CML by targeting specific proteins in cancer cells.

Currently, the ten-year survival rate for the most prevalent type of CML is approximately 85%[4]. This means that patients can anticipate lifespans nearly equivalent to healthy adults if they receive proper treatment and care. It is essential to monitor and manage any side effects associated with treatment to ensure optimal outcomes.

It is worth noting that around 90 out of every hundred people (approximately 90%) will survive leukaemia for more than five years following their diagnosis[5]. While this may provide some comfort, it is crucial to seek medical attention promptly if any symptoms or changes in health occur.

In conclusion, while chronic myeloid leukemia can be a challenging condition to manage, there are effective treatments available that can significantly improve patient outcomes. It is essential to work closely with healthcare professionals and adhere to recommended treatments to ensure optimal results. With proper care and management, individuals living with CML can live long and fulfilling lives.

Citations:

[1] https://www.myleukemiateam.com/resources/chronic-myeloid-leukemia-survival-rates-and-outlook

[2] https://www.healthline.com/health/chronic-myeloid-leukemia/outlook-life-expectancy

[3] https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/detection-diagnosis-staging/survival-rates.html

[4] https://www.lls.org/research/chronic-myeloid-leukemia-cml

[5] https://www.cancerresearchuk.org/about-cancer/chronic-myeloid-leukaemia-cml/survival

Chronic liver disease can affect brain health

Chronic liver disease has the potential to impact brain health in a multitude of ways. One prevalent neurological disorder that arises from liver damage is “hepatic encephalopathy,” which entails the degradation of cognitive function as a result of toxins building up in the bloodstream, typically filtered by the liver. The manifestation of hepatic encephalopathy can encompass symptoms such as confusion, anxiety, mood fluctuations, memory impairments, sleep disturbances and even comatose states.

Chronic liver disease may lead to brain damage through the accumulation of manganese in the cerebral cortex, resulting in a syndrome akin to Parkinson’s disease. Manganese is typically eliminated by the liver; however, when hepatic function is compromised, it can accumulate within the bloodstream and settle within specific regions of the brain, particularly those controlling movement such as the basal ganglia.

Chronic liver disease may lead to neuroinflammation, which involves the stimulation of immune cells in the brain that generate inflammatory molecules. Neuroinflammation can hinder neuronal function and viability, as well as contribute to cognitive deterioration and neurological ailments.

Hence, the persistence of liver disease can result in grave ramifications on cognitive processes and brain well-being. It is therefore crucial to promptly seek medical aid and therapy if any indications or signs of hepatic complications or neurological dysfunction arise.

Lactulose and rifaximin serve as the primary pharmacological interventions for hepatic encephalopathy; however, they may elicit certain adverse reactions. Among the potential side effects include.

The diagnosis of hepatic encephalopathy relies on the identification of neurological symptoms, liver function assessments, blood ammonia level examinations and other tests aimed at eliminating alternative causes of brain dysfunction¹². In certain instances, an electroencephalogram (EEG) or a brain imaging scan (CT or MRI) may be conducted to evaluate cerebral activity and structure¹².

Management of hepatic encephalopathy is contingent upon the severity and etiology of the ailment. The primary objectives comprise eradicating toxins from circulation, rectifying predisposing factors, and forestalling reoccurrence¹². Several conventional therapeutic alternatives encompass::

Lactulose: a non-absorbable sugar that lowers the pH of the colon and inhibits the growth of ammonia-producing bacteria. It also acts as a laxative and helps eliminate toxins through stool¹².

Rifaximin: an antibiotic that reduces the number of ammonia-producing bacteria in the gut. It is often used in combination with lactulose for patients with recurrent or persistent hepatic encephalopathy¹².

Other antibiotics: such as neomycin or metronidazole may be used as alternatives to rifaximin, but they have more side effects and are less effective¹².

Zinc supplementation: zinc deficiency is common in patients with liver disease and may contribute to hepatic encephalopathy by impairing the metabolism of ammonia. Zinc supplementation may improve cognitive function and reduce ammonia levels in some patients¹².

Liver transplantation: this is the definitive treatment for patients with end-stage liver disease and severe or recurrent hepatic encephalopathy. It can restore normal liver function and eliminate portal-systemic shunting¹².

In addition to these treatments, it is important to identify and correct any precipitating factors that may trigger or worsen hepatic encephalopathy, such as infections, bleeding, dehydration, electrolyte imbalance, constipation, medications or dietary changes¹². Patients should also avoid alcohol and limit protein intake to avoid excess ammonia production¹².

Source: Conversation with Bing, 6/24/2023

(1) . https://bing.com/search?q=hepatic+encephalopathy+diagnosis+treatment.

(2) Hepatic Encephalopathy: Diagnosis and Management – PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7805282/.

(3) Hepatic encephalopathy – Symptoms, diagnosis and treatment | BMJ Best …. https://bestpractice.bmj.com/topics/en-gb/294.

(4) Treating Hepatic Encephalopathy – American Liver Foundation. https://liverfoundation.org/liver-diseases/complications-of-liver-disease/hepatic-encephalopathy/treating-hepatic-encephalopathy/.

Source: Conversation with Bing, 6/24/2023

(1) Hepatic Encephalopathy: Types, Causes, Symptoms, Treatment. https://my.clevelandclinic.org/health/diseases/21220-hepatic-encephalopathy.

(2) When a diseased liver disrupts the brain: Chronic liver diseases cause …. https://www.sciencedaily.com/releases/2019/08/190819110007.htm.

(3) Neurologic Manifestations of Chronic Liver Disease and Liver Cirrhosis. https://pubmed.ncbi.nlm.nih.gov/25908229/.

Source: Conversation with Bing, 6/24/2023

(1) Rifaximin Uses, Side Effects & Warnings – Drugs.com. https://www.drugs.com/mtm/rifaximin.html.

(2) Rifaximin Side Effects: Common, Severe, Long Term – Drugs.com. https://www.drugs.com/sfx/rifaximin-side-effects.html.

(3) Side effects of lactulose – NHS. https://www.nhs.uk/medicines/lactulose/side-effects-of-lactulose/.

(4) Why do we use Lactulose and Rifaximin for Hepatic Encephalopathy …. https://www.aasld.org/liver-fellow-network/core-series/why-series/why-do-we-use-lactulose-and-rifaximin-hepatic.

What are the treatment options for colorectal cancer?

Treatment options for colorectal cancer depend on the stage and extent of the disease. The most common treatment for colorectal cancer is surgery, which may involve removing tumors, removing the affected section of the colon, reattaching healthy ends of the intestines, and removing nearby lymph nodes. In rare cases, the entire colon may need to be removed[1][2]. Patients may receive chemotherapy and/or radiation therapy before and/or after surgery for colorectal cancer[1][3][2].

Other treatment options for colorectal cancer include immunotherapy, biological therapy, biosimilars, liver-directed therapy, radiofrequency ablation, cryosurgery, targeted therapy, and clinical trials[1][3][4][5][6]. The specific course of treatment will depend on the exact location of the cancer and how early it was found.

Treatment for colon cancer may also include endoscopic treatment[2]. The higher stages of cancer require advanced treatment options[3]. People with stage II colorectal cancer should talk with their doctor about whether more treatment is needed[6]. It is important to discuss treatment options with a multidisciplinary care team, a group of doctors who specialize in various fields of medicine related to treating cancer of the colon or rectum[1].

Citations:
[1] https://www.cancercenter.com/cancer-types/colorectal-cancer/treatments
[2] https://www.hopkinsmedicine.org/health/conditions-and-diseases/colon-cancer/colon-cancer-treatment
[3] https://www.ccalliance.org/colorectal-cancer-information/treatments
[4] https://fightcolorectalcancer.org/facing-colorectal-cancer/diagnosis-and-treatment/know-your-treatment-options/
[5] https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq
[6] https://www.cancer.net/cancer-types/colorectal-cancer/types-treatment

By Perplexity at https://www.perplexity.ai/search/46847b64-b568-4861-935e-79867feb004d

what are the treatment options for cirrhosis of the liver?

Treatment for cirrhosis depends on the cause of the disease and whether complications are present. The goals of treatment are to slow the progression of scar tissue in the liver and prevent or treat the complications of the disease. Here are some treatment options for cirrhosis of the liver:

  1. Lifestyle changes: Avoiding alcohol, quitting smoking, losing weight if overweight or obese, and doing regular exercise to reduce muscle loss can help reduce the chances of further problems and complications[1].
  2. Medications: The medicine you need will depend on what caused the damage to your liver. For example, if cirrhosis is from long-term viral hepatitis, you may be prescribed antiviral medicine. You may be offered medicines to ease the symptoms of cirrhosis, such as diuretics, which are used in combination with a low-salt diet to reduce the amount of fluid in your body, which helps with swelling (oedema), and prescription creams to ease skin itching[1][2].
  3. Treating the complications of cirrhosis: Treatments for the complications of cirrhosis include portal hypertension, which is treated with beta-blockers, and hepatic encephalopathy, which is treated by cleansing the bowel with lactulose, a laxative given orally or in enemas[3].
  4. Liver transplant: If cirrhosis progresses and your liver is severely damaged, a liver transplant may be the only treatment option. This is a major operation that involves removing your damaged liver and replacing it with a healthy liver from a donor[1][4].

In summary, treatment for cirrhosis depends on the cause of the disease and whether complications are present. Lifestyle changes, medications, treating the complications of cirrhosis, and liver transplant are some of the treatment options available.

Citations:
[1] https://www.nhs.uk/conditions/cirrhosis/treatment/
[2] https://www.webmd.com/digestive-disorders/understanding-cirrhosis-treatment
[3] https://surgery.ucsf.edu/conditions–procedures/end-stage-liver-disease-(esld).aspx
[4] https://www.mayoclinic.org/diseases-conditions/cirrhosis/diagnosis-treatment/drc-20351492

By Perplexity at https://www.perplexity.ai/search/90dce8a9-e6e8-42df-a62e-a2cd87aa24d2

Is Untreated cirrhosis of the liver is a fatal disease?

Untreated cirrhosis of the liver is a potentially fatal disease[1][2][3], as its damage is irreversible and can eventually lead to complete liver failure[1]. In the UK alone, about 4,000 individuals die from this condition annually while approximately 700 require a liver transplant in order to survive[1]. Notably, cirrhosis ranks among the top ten causes of death in the United States and life expectancy varies depending on both its type and stage[4]. Nevertheless, it generally takes years for such progression to culminate in full-blown liver failure. Treatment options are available that may help impede this process[1], with early diagnosis being particularly crucial for successful recovery outcomes[5].

Citations:

[1] https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/cirrhosis

[2] https://www.medicalnewstoday.com/articles/cirrhosis-of-the-liver-life-expectancy

[3] https://my.clevelandclinic.org/health/diseases/15572-cirrhosis-of-the-liver

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017060/

[5] https://www.griswoldhomecare.com/blog/2018/august/living-with-cirrhosis-of-the-liver-life-expectan/

what are the common causes of cirrhosis of the liver?

Cirrhosis of the liver is a pathological condition characterized by the replacement of healthy hepatic cells with fibrous tissue, which can be fatal if not treated promptly. The most prevalent causes of this disease are prolonged and excessive alcohol consumption as well as infection with hepatitis B or C viruses[1][2][3][4]. Nevertheless, there exist other afflictions that may induce liver damage and cirrhosis such as non-alcoholic fatty liver disease, autoimmune liver disease, primary biliary cholangitis, bile duct disorders, and certain drugs[3][5]. Moreover, being overweight or afflicted by high blood pressure, diabetes or pre-diabetes conditions along with elevated cholesterol levels also pose significant risks for developing cirrhosis[5]. It should be noted that not all individuals exhibiting these risk factors will necessarily develop cirrhosis[2].

Citations:

[1] https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/cirrhosis

[2] https://www.mayoclinic.org/diseases-conditions/cirrhosis/symptoms-causes/syc-20351487

[3] https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cirrhosis-of-the-liver

[4] https://www.nhs.uk/conditions/cirrhosis/

[5] https://www.mountsinai.org/health-library/diseases-conditions/cirrhosis

Hepatitis B and C are viral infections that can elicit liver inflammation and damage, ultimately resulting in cirrhosis of the liver. The viruses have the ability to infect hepatocytes and provoke an immune response leading to hepatic irritation and fibrosis[1][2]. Over time, this fibrosis may become so widespread as to impede proper hepatic function, culminating in liver failure or death if untreated[3][4]. Genetic and epigenetic factors such as microRNAs drive progression from cirrhosis towards hepatocellular carcinoma (HCC) in chronic hepatitis B and C infections[4]. Literature suggests that multiple severe acute exacerbations, hepatic decompensation, and reversion to HBeAg are all associated with progression towards cirrhosis[3]. Hepatitis B infection-related inflammation may result in extensive scarring of the liver (cirrhosis), which could compromise its normal functioning capacity[5]. Individuals with suppressed immunity who suffer from chronic hepatitis B are prone to reactivation[5].

Citations:

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168079/

[2] https://www.intechopen.com/chapters/62719

[3] https://journals.asm.org/doi/10.1128/cmr.00018-11

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6470669/

[5] https://www.mayoclinic.org/diseases-conditions/hepatitis-b/symptoms-causes/syc-20366802

Hepatitis viruses do not directly cause liver cell necrosis. Instead, they infect liver cells, which triggers an immune response resulting in inflammation and cellular damage leading to viral-induced apoptosis via the induction of the death receptor-mediated signaling pathway[1][2]. The severity of liver damage is regulated by Hepatitis B virus genotypes and viral components[3][4]. The demise of liver cells prompts the dispatching of inflammatory cells to the affected area, instigating inflammation and fibrosis[5]. Given that death receptors are ubiquitously expressed throughout the organ, hepatocytes and cholangiocytes are highly susceptible to death receptor-mediated apoptosis. Necrosis in the liver is typically associated with acute injury (such as ischemia/reperfusion injury) and has long been viewed as an unregulated process.[2]

Citations:

[1] https://en.wikipedia.org/wiki/Hepatitis

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867948/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168079/

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC98986/

[5] https://hepctrust.org.uk/information/impact-hepatitis-c-liver/hepatitis-c-and-liver-damage

Cirrhosis of the liver is a grave ailment that leads to fibrosis and enduring impairment of the hepatic organ[1][2][3][4][5]. This condition commonly results from liver destruction instigated by factors such as chronic alcohol consumption, hepatitis B or C infections, or fatty liver disease associated with diabetes and obesity[5]. Notably, cirrhotic damage is generally irreversible; however, early detection coupled with proper therapy may decelerate its progression depending on the underlying cause[3].

There exist two distinct phases of cirrhosis: compensated and decompensated[1][2]. Those with compensated cirrhosis are asymptomatic, while the average life expectancy is approximately 9-12 years[1]. Although a percentage of individuals will develop symptoms each year (5-7%)[1], many people may remain asymptomatic for an extended period. Decompensated cirrhosis signifies that the disease has progressed to the point where noticeable symptoms manifest in affected individuals[2]. Median survival time among patients with decompensated cirrhosis is roughly two years[2].

Cirrhosis has the potential to be lethal if hepatic function is compromised[4]. Nonetheless, it typically requires several years for the ailment to progress to this point and medical intervention can assist in decelerating its advancement[4]. In the UK, approximately 4,000 individuals perish annually from cirrhosis while 700 patients with this disease necessitate a liver transplant to survive[4]. Indicators and symptoms of cirrhosis encompass weariness, feebleness, loss of weight, queasiness and vomiting, abdominal discomforts, jaundice as well as edema in both the legs and abdomen regions[4].

To summarize, liver cirrhosis is a grave ailment that engenders scarring and irreversible harm to the liver. The prognosis of this condition hinges on its stage and type, while treatment options can help decelerate its advancement. Indications and manifestations consist of exhaustion, feebleness, loss of mass, queasiness, vomiting, abdominal discomfort, jaundice as well as edema in the legs or abdomen.

Citations:

[1] https://www.medicalnewstoday.com/articles/cirrhosis-of-the-liver-life-expectancy

[2] https://my.clevelandclinic.org/health/diseases/15572-cirrhosis-of-the-liver

[3] https://www.mayoclinic.org/diseases-conditions/cirrhosis/symptoms-causes/syc-20351487

[4] https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/cirrhosis

[5] https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cirrhosis-of-the-liver

Breast cancer: ribociclib reduces the risk of recurrence by 25%

Breast cancer is the second most common cancer in women worldwide and is responsible for a significant number of deaths. Hormone receptor-positive, HER2-negative advanced breast cancer is one of the most common subtypes of breast cancer and is typically treated with a combination of hormone therapy and chemotherapy. However, despite the advances in breast cancer treatment, many patients still experience recurrence of their cancer, which poses a significant clinical challenge.

Ribociclib is a targeted therapy drug that has shown promising results in reducing the risk of recurrence in patients with hormone receptor-positive, HER2-negative advanced breast cancer. In clinical studies, ribociclib has been shown to inhibit the activity of CDK4/6, which controls the cell cycle of cancer cells. When used in combination with other treatments, such as hormone therapy, ribociclib has been shown to significantly reduce the risk of cancer recurrence by up to 25%.

It is worth noting that ribociclib is not suitable for all breast cancer patients. It is typically prescribed for those with hormone receptor-positive, HER2-negative advanced breast cancer who have not yet received any treatment or who have already received treatment with hormone therapy, but whose cancer has progressed despite this treatment. Ribociclib can cause side effects, as is the case with most drugs, and you should discuss the risks and benefits with your healthcare provider if you are considering this treatment. Your healthcare provider can advise you on the best treatments for your specific situation, as well as any clinical trials that may be available to you.

Sources:

1 novartis

2 asco

3 theguardian

4 cnn

5 everydayhealth

Osimertinib has been shown to halve the risk of death from certain lung cancers when taken daily after surgery

Certainly! The discovery and development of effective cancer treatments is a crucial area of research, as cancer continues to be one of the leading causes of death worldwide. Osimertinib is a targeted therapy that works by inhibiting the activity of a specific protein that is commonly found in certain types of lung cancer cells. This protein helps the cancer cells grow and divide, so by blocking its activity, osimertinib can slow the progression of the disease.

The study that was published recently looked at the use of osimertinib in patients with stage II to IIIA non-small-cell lung carcinoma who had undergone surgery to remove the tumor. The participants were randomly assigned to receive either osimertinib or a placebo for up to three years. The researchers found that those who took osimertinib had a significantly lower risk of their cancer returning or of death compared to those who took the placebo.

One of the benefits of targeted therapies like osimertinib is that they tend to have fewer side effects than traditional chemotherapy, which can cause damage to healthy cells in addition to cancer cells. This can improve the overall quality of life for patients undergoing treatment and make it easier for them to manage the side effects that do occur.

Overall, the study provides a promising new treatment option for patients with non-small-cell lung carcinoma who have undergone surgery. While more research is needed to fully understand the potential benefits and risks of long-term osimertinib use, this study represents an important step forward in the fight against cancer.

1 cancerresearchuk

2 cancer

3 nejm

Home-grown plants may help reduce cancer risks

Sydney: Planting plants in homes can help reduce your risk of developing cancer, according to a study.

Researchers from the University of Technology Sydney in Australia, in collaboration with a company called Embius, found that home plants can clear toxic vapors, including cancer-causing particles, from the building.

In the first study of its kind, the ability of plants to purify gasoline vapor was tested. This evaporation is one of the main causes of toxic compounds in buildings around the world.

The plants studied had cleared 97 percent of the harmful vapors from the air in just eight hours.

According to the World Health Organization, indoor air pollution caused 3.2 million premature deaths in 2020.

The inhalation of gasoline vapor can cause inflammation, headache and nausea in the lungs. Prolonged exposure to these vapours is associated with an increased risk of cancer, asthma and other chronic diseases.

University researchers claim that most people spend 90 percent of their time indoors, offices or schools, so improving air quality is important.

According to the researchers, there are garages with many job sites, homes and even schools, or these buildings are along a busy road or near a petrol station, as a result of which people in these buildings are exposed to petrol-related chemicals on a daily basis.

For the research, they built nine green walls. It is a vertical structure to which different plants and or greenery are attached.

What is Chronic Myeloid Leukemia?

Chronic Myeloid Leukemia is classified as a myeloproliferative neoplasm (MPN). It is therefore a malignant disease of the bone marrow’s blood-forming cells that causes an uncontrolled expansion of leukocytes (white blood cells) in the blood, particularly mature and maturing granulocytes (progenitor cells). The quantity of blood platelets is frequently raised at the start of the disease (thrombocytosis).

Learn more about CML :  It is a cancer that affects the bone marrow and blood cells

Which factors lead to CML?

Chemical compounds such as benzene and radioactive radiation from Hiroshima and Nagasaki are risk factors. Both of these variables can cause bone marrow blood stem cells to deteriorate. The leukemia cells in approximately 90% of people with chronic myeloid leukemia contain a unique genetic abnormality known as the Philadelphia chromosome. It is the outcome of a genetic material exchange between chromosomes 9 and 22. (a so-called bcr-abl1 fusion gene). According to current research, heredity does not play a role.

What are the symptoms of CML?

Chronic myeloid leukemia (CML) usually begins insidiously and can last for several years. It is often detected by a routine blood test as part of a preventive medical check-up, and can cause an enlargement of the spleen and pain in the upper left abdomen. In advanced stages, leukemia causes the number of healthy, functioning blood cells to decrease, leading to a disruption of all three cell rows.

  • Lack of erythrocytes ( anemia ): weakness, paleness, reduced performance, shortness of breath
  • Lack of platelets (thrombocytopenia): Increased tendency to bleed, which can show up as nosebleeds or bruising (hematomas).
  • Lack of functional white blood cells: Increased susceptibility to infections

The sometimes overwhelming rise in white blood cells can also contribute to the formation of clots and vascular occlusions, but this is uncommon due to the mature cells’ good deformability. In this scenario, we’re talking about leukemic thrombi.

How is CML diagnosed?

History and physical examination

The doctor begins with a thorough discussion of present symptoms and potential risk factors ( anamnesis ). He next checks the spleen and liver, among other organs, which can swell with CML. An ultrasound examination of the abdomen can also be used to measure the size of the organs.

Blood test

The blood shows characteristic alterations. The number of white blood cells (leukocytes) is dramatically raised in the complete blood count, owing to a rise in the number of mature and immature granulocytes. Platelets in the blood may be raised as well. When CML has progressed, there is a paucity of red blood cells (anemia) and blood platelets.

Bone marrow examination

Following the blood test, a bone marrow examination is required to confirm the diagnosis. Under local anesthetic, bone marrow is extracted from the iliac crest (punch biopsy). This test is often performed as an outpatient procedure, requiring no hospitalization.

Evidence of genetic modification: The Philadelpia chromosome


Cytogenetic examinations can detect the Philadelphia chromosome, which is a translocation of genes 9 and 22 in the blood and bone marrow. Rarely, this gene change can be found in acute leukemia, but the course of the disease and treatment differ from normal CML.

How is CML treated?


Hematological response to therapy

Under therapy, the blood count returns to normal, which is referred to as the haematological response. The spleen has recovered to normal size as well. This stage is usually reached a few weeks after starting therapy.

Cytogenetic response to therapy


In the case of a cytogenetic response, bone marrow cells in the division phase are inspected microscopically. The cytogenetic reaction is reflected in fewer cells carrying the Philadelphia chromosome. When the Philadelphia chromosome is no longer detectable, it is said to be in complete cytogenetic remission. This milestone is usually reached after roughly six months.

molecular response to therapy

The polymerase chain reaction can be used to detect the bcr-abl transfusion gene (PCR). A good molecular remission is defined as the bcr-abl value falling below 0.1 percent of the original value. This goal should have been met 12 months after starting therapy.

Tyrosinkinasehemmer

Cancer specialists use tyrosine kinase inhibitors, especially imatinib, as standard therapy for chronic myeloid leukemia (CML). Newer tyrosine kinase inhibitors, such as nilotinib and dasatinib, are now also approved for the initial treatment of CML. At the beginning of treatment with imatinib, the drug can cause changes in the blood count, nausea, diarrhea, water retention in the tissue (edema), skin rashes, and muscle cramps. However, the side effects decrease with increasing duration of therapy. It is important to use the prescribed medication regularly, and therapy is often lifelong. If there is an optimal response, stopping or pausing the tyrosine kinase inhibitor can be attempted, preferably as part of a study. If there is a lack of response, a change in tyrosine kinase inhibitors is also an option.

Other drug therapy options

Since tyrosine kinase inhibitors were approved for the treatment of CML in 2002, other therapies have taken a back seat. They are still employed, however, when the response to tyrosine kinase inhibitors is insufficient. Interferon-alpha, hydroxyurea, and chemotherapeutic medicines are among the medications utilized here.