Monday, August 8, 2011

Chronic Myelogenous Leukemia: The Second Phase aka The Accelerated Phase

The accelerated phase of chronic myelogenous leukemia is the phase that can develop after the chronic phase, but before the blast crisis phase. It is a transitional phase that may lead to blast crisis. During the accelerated phase, leukemia cells begin to build up in the body more quickly. In this phase, the leukemia cells often acquire new gene mutations helping them to outsmart the TKI’s (tyrosine kinase inhibitor).

Patients that are diagnosed in this phase may feel ill and actually develop symptoms from the disease. Anemia may develop or progress causing fatigue and the white cell count may either fall to very low levels or rise because of the accumulation of blast cells. Platelet counts generally decrease. The blast cells now make up 10%-19% of the cells in the blood and bone marrow.

The treatment for this phase of CML will depend upon what treatments the patient has already had. In general, the treatments are similar to the treatments of patients that are diagnosed in the chronic phase, however, patients in the accelerated phase are less likely to have a long-term response to any treatment.
TKI’s, Gleevec (Imatinib), Tasigna (Nilotinib) and Sprycel (Dasatinib) are still an option for most people, but the dosage is often higher. Interferon, cytarabine, hydroxyurea, busulfan and bone marrow transplants may be an option for patients in the accelerated stage. The treatment goal during the accelerated phase is to regain control of the disease and to return it to the chronic phase.

This phase is quite a bit more serious than the chronic phase and can easily progress into blast crisis if untreated. If you begin to feel unusually fatigued, weak or ill, notice a significant loss of appetite or weight loss, start running a fever or have fullness or tightness in your abdomen, particularly under your left rib cage, please make an appointment with your oncologist.

The statistics that I have found state that about 50% of patients in accelerated phase of CML are alive after four years. I don’t know if that means that they are not alive after five, or that is the length of time that they have been following these patients, whatever the statistics, I know that if I develop any significant changes, I will be calling my doctor!

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