Diagnosing Chronic Myelogenous (Myeloid) Leukemia (CML)

Overview

Chronic myelogenous leukemia (CML) is a type of blood and bone marrow disease characterized by the overproduction of white blood cells. To diagnose CML, doctors may perform several examinations, screening tests, and procedures. These include:

• Physical examination: A doctor will conduct a thorough physical examination to look for signs and symptoms of CML, such as enlarged spleen or liver.
• Medical history: The doctor will review the person's medical history to identify any risk factors or previous health conditions that may contribute to the development of CML.
• Complete blood count (CBC): This test measures the levels of red blood cells, white blood cells, and platelets in the blood. In CML, there is often an increased number of white blood cells, specifically immature white blood cells called blast cells.
• Peripheral blood smear: This test involves examining a drop of blood under a microscope to identify any abnormal changes in the shape or structure of blood cells, which can indicate CML.
• Molecular testing: This type of testing looks for specific genetic changes, such as the Philadelphia chromosome (a genetic abnormality commonly associated with CML), which confirms the diagnosis of CML.
• Bone marrow biopsy: A bone marrow biopsy involves taking a small sample of bone marrow tissue from the hipbone using a needle. This sample is then examined under a microscope to check for the presence of abnormal cells indicative of CML.
• Cytogenetic testing: This test analyzes the chromosomes within the bone marrow cells to identify any genetic abnormalities associated with CML, such as the presence of the Philadelphia chromosome.
• Polymerase chain reaction (PCR): PCR is a type of genetic test that can detect and monitor specific genetic changes in the bone marrow cells, including those related to CML.
• FISH (Fluorescence In Situ Hybridization): FISH is a type of genetic test that can detect specific chromosomal abnormalities associated with CML.
• Imaging studies: In some cases, imaging studies like X-rays, CT scans, PET scans or ultrasounds may be performed to assess the extent of organ involvement or detect any complications related to CML.

Specialists who may be involved in diagnosing CML include hematologists (doctors specializing in blood disorders) and oncologists (doctors specializing in cancer treatment). These specialists have expertise in interpreting diagnostic tests and determining appropriate treatment options for CML.