Chronic Myeloid Leukemia (CML)

The news of NBA legend Kareem Abdul-Jabbar's diagnosis with Chronic Myeloid Leukemia (CML) calls for a primer on that "other" hematologic cancer, leukemia.

Leukemias arise in the bone marrow, where your body makes both red and white blood cells, causing problems in the blood- like anemia (low red cells), or immune system issues, such as low white infection-fighting blood cell counts, which opens the way to often serious infections in the bloodstream.

Kareem is one of about 5,000 people in the US diagnosed annually with CML (you'll see and hear it called Chronic Myelogenous Leukemia and Chronic Myeloid Leukemia; it's the same thing).

Classification

Leukemias are classified in two important ways.

The first is as either Acute or Chronic. Long story short, the Chronic leukemias have the more favorable diagnoses because they're indolent, or slow-growing, and sometimes don't require treatment for years. The Acute leukemias are aggressive and life-threatening; they come on very quickly, and patients can sometimes die within weeks of being diagnosed.

The second is as either Myeloid or Lymphoid. If Myeloid, it means the cancer involves the myeloid cells, which are the white blood cells that create neutrophils, which our bodies need to fight foreign bacteria. If Lymphoid, it means the cancer involves the lymphoid cells, the white blood cells that create lymphocytes, which our bodies need to fight off anything non-bacterial.

Staging

Unlike other cancers, leukemias do not have a formal staging process. So you won't hear that Kareem has "stage II CML" or anything like that. This is true for all the leukemias except Chronic Lymphocytic Leukemia (CLL), which has four stages. Many authorities regard Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma (SLL) as being the same disease.

However, leukemias do go through increasingly serious phases. For instance, CML has three phases:

Chronic: Most patients are diagnosed during this phase, and tend to have few symptoms since their white blood cells are still doing their jobs.
Accelerated: Here, the white cell count might fluctuate, causing anemia or the spleen to swell, and making the patient feel sick.
Blast Crisis: Once CML reaches this phase, it turns into an Acute leukemia, and gets rather drastic.

Treatment

Treatment for Chronic Myeloid Leukemia features one of the monumental—and sadly, few—success stories in the history of cancer and medicine.

In 2001, the targeted therapy agent imatinib mesylate (sold as Gleevec) got FDA approval and became for CML sufferers what Kareem often was on the court for the Bruins and Lakers: a game-changer.

Gleevec has amounted to a five-year survival rate of 90%, meaning in cancer-speak, that it's as good as a 'cure' as you'll find in this field for many patients.

Unfortunately, not all CML patients respond to Gleevec. The good news is that the FDA recently fast-tracked a drug called omacetaxine mepesuccinate, which has shown in trials to be effective in treating patients whose CML is Gleevec-resistant.

However, news reports seem to indicate that Kareem is on Gleevec. For example, espn.com said "Abdul-Jabbar is taking an oral medication for the disease. He is a paid spokesman for the Swiss pharmaceutical company Novartis, which makes a drug that treats the illness."

Novartis makes Gleevec.

More information

You can read more about CML's phases as well as risk factors and other information on CML at the Leukemia and Lymphoma Society's CML page or at their CML Guide.