Disease progression of chronic myeloid leukemia

Last medical review:

Cancer cells can spread from where they start to other parts of the body. Leukemia is a cancer of the blood-forming tissue in the bone marrow, and it can spread wherever the blood travels.

Understanding how chronic myeloid leukemia (CML) usually progresses helps your healthcare team plan your treatment and future care.

CML usually progresses slowly. The granulocytes with the BCR-ABL gene (called leukemia cells or CML cells) gradually start building up in the blood and bone marrow. Over time, other genetic changes occur. These changes are called additional chromosome abnormalities (ACAs). They make blast cells reproduce more quickly. As a result, the number of blast cells in the bone marrow increases and they start to appear in large numbers in the blood. These blast cells crowd out the healthy red blood cells, white blood cells and platelets.

As CML progresses, you may have the following symptoms:

  • fatigue that slowly gets worse
  • pain in your left side near the ribs from a swollen spleen
  • feeling full after eating a small amount of food (early satiety), which can happen when the spleen is swollen and stops the stomach from expanding when you eat
  • weight loss
  • frequent infections
  • bone pain

Expert review and references

  • Jeffrey H Lipton, PhD, MD, FRCPC
  • Cancer Research UK. Chronic Myeloid Leukemia (CML): Stages. 2019.
  • Gambacorti-Passerini C & le Coutre P. Chronic myeloid leukemia. DeVita VT Jr., Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 11th ed. Philadelphia, PA: Wolters Kluwer; 2019: Kindle version, ch 104, https://read.amazon.ca/?asin=B0777JYQQC&language=en-CA.
  • Leukemia & Lymphoma Society . The CML Guide: Information for Patients and Caregivers . 2019 : https://www.lls.org/.
  • National Comprehensive Cancer Network . NCCN Guidelines for Patients: Chronic Myeloid Leukemia . 2021 : https://www.nccn.org/.
  • Schiffer CA. Diagnosis and treatment of chronic myeloid leukemia. Wiernik PH, Dutcher JP, Gertz MA, eds.. Neoplastic Diseases of the Blood: Volume 1. 6th ed. New York, NY: Springer; 2018: 5:49-68.