Diagnosis

About half of all people with Chronic Myeloid Leukemia do not have symptoms at the time the disease is diagnosed. In these people the disease is found during routine blood tests.

Blood tests are done to count the different types of blood cells. A blood sample is looked at under the microscope and if an abnormally high number of mature and maturing white blood cells are noted, a bone marrow biopsy may be done.

The bone marrow sample is taken by a needle inserted into the bone. A small amount of bone marrow is taken and looked at under the microscope. A diagnosis of CML is based on the finding of the Philadelphia chromosome in cells of the bone marrow.

The Phases of Chronic Myeloid Leukemia

CML progresses through three phases. The number of blasts in the blood and bone marrow and the severity of symptoms help doctors determine which phase of CML a patient is in.

• Chronic phase. In this phase there are few blasts (fewer than 5%) in the blood and bone marrow. There may be no symptoms of CML or symptoms may be mild. This phase can last for a few months to several years. Most cases of CML are diagnosed at this phase.
• Accelerated phase. The number of blast cells increases to about 15%. This phase can last weeks to months.
• Blastic phase, or blast crisis. More than 30% of cells are blasts. Sometimes blast cells will form tumors outside of the bone marrow in the bone or lymph nodes. At this point chronic leukemia has become an aggressive acute leukemia.

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