Pathogenesis, Origin and Modern Clinical Diagnostic Methods of Chronic Myeloid Leukemia

Abstract

Chronic myelogenous leukemia (CML) develops as a result of malignant transformation and clonal proliferation of pluripotent stem cells, leading to hyperproduction of mature and immature granulocytes. The disease is initially asymptomatic; Progression is latent, in a nonspecific "benign" phase (malaise, loss of appetite, weight loss) gradually progresses to an exacerbation phase or blast crisis, with specific signs of the disease such as splenomegaly, pallor, bleeding, fever, lymphadenopathy and skin changes. The diagnosis is made on the basis of examination of peripheral blood smears, bone marrow aspirates and detection of the Philadelphia chromosome. The use of tyrosine kinase inhibitors (TKIs) such as imatinib, dasatinib, nilotinib, bosutinib and ponatinib significantly improves treatment outcomes and increases the life expectancy of patients with CML. Also, myelosuppressive drugs (for example, hydroxyurea - not registered in the Russian Federation), hematopoietic stem cell transplantation, and the use of interferon alpha are sometimes used in the treatment of CML.