General Leukemia Questions
Is leukemia inherited?
Chronic Myeloid Leukemia is a genetic disease, but not a hereditary disease. The majority of leukemia patients have no family history of the disease and there is no evidence that it can be passed on to the children of someone living with the disease. Occasionally, there are families that may have other members living with leukemia, however, there is no conclusive evidence that family members are predisposed to develop leukemia.
Can leukemia be acquired through a blood transfusion?
Because there is no known cause of leukemia, the only way it could be acquired through a blood transfusion would be the the direct introduction of leukemic cells in the recipient. However, because the cells of a random donor would be seen as foreign, they would be immediately destroyed by the recipient. There is no evidence that leukemia has ever been acquired from a blood transfusion.
Are blood transfusions safe?
Yes. Today's screening processes exclude transmission of infectious agents. All donated blood (units) is screened for HIV, hepatitis B and hepatitis C.
There are a variety of other considerations such as noninfectious risks such as sudden destruction on the transfused red cells or even late destruction of the transfused red cell. However, these are very rare and the benefit outweighs the very small risk.
In some individuals with congestive heart failure, circulatory
What are the survival rates for CML?
The advent of tyrosine kinase inhibitors, has dramatically extended the expected life span of patients living with CML. Life expectancy was once only 3-7 years after the diagnosis of CML was determined. Today we measure life expectancy in decades with most individuals living with CML anticipating a normal lifespan.
The National Cancer Institute's Surveillance Epidemiology and End Results (SEER) database published findings about cancer and survival from 2005 - 2009 in the United States. From 2005 - 2009 CML patients lived to the median age of 75 years (72 years for men and 78 years for women). The World Bank reports that the average life expectancy across the US is 78.24 years in 2010. Individuals being treated for CML now experience closely comparable life expectancy rates to the general US population.
- Approximately 1 in 599 people will be diagnosed with CML in their lifetime.
- Approximately 4800 people are diagnosed each year in the United States with estimates ranging from 4500 to 5500.
- There are an estimated 70,000 people living with CML in the United States (US) as of 2010.
- That number will continue to grow until a plateau is reached near the year 2050, at which time we expect there to be about 181,000 people living with CML in the US.
- There are differences based on gender, age and ethnicity, that will influence your risk of developing CML, as well as your overall expected survival with CML.
Based on the SEER Report, the incidence (how many people are diagnosed with CML in one year) of people developing CML is slightly lower than it was in 2001 and before. However, the prevalence (people currently living with CML) is much higher and this number will continue to grow until about the year 2050. The definitions of many of the statistics we read, may be confusing. Many people find that reading the primary definitions on the SEER website can be helpful in understanding what the statistics actually mean.
The journal CANCER published an article by Drs. Huang, Cortes and Kantarjian from MD Anderson Cancer Center in January 2012 (online), which focuses on the changes in the population of individuals living with CML in the United States and the changes expected in incidence, prevalence and survival statistics. An abstract of that article is available for your review and the information it outlines, provides a glimpse into the future of CML for the next generation.
What are the differences between AML and CML?
AML or Acute Myelogenous Leukemia is an acute form of leukemia that can develop quite rapidly. This form of leukemia is treated with chemotherapy and potentially a bone marrow/stem cell transplant should the disease not go into remission. Most AML patients quickly notice acute symptoms associated with the disease.
CML or Chronic Myelogenous Leukemia is a slow growing form of leukemia affecting the myeloid cells in the marrow. Many are diagnosed serendipitously while seeing their doctor for a regular physical or appointment. There have even been those diagnosed after their optometrist suggested they see their regular physician. Many have no symptoms at all and are completely unaware that they even had CML. Some may present with an enlarged spleen, fatigue, or other symptoms that might not be readily recognized as extreme.
Is my CML curable? Currently all of my lab tests are normal and are taken weekly. My Oncologist tells me I have to take this medication for life.
With CML, patients are required to take a therapy drug indefinitely in order to keep the disease from reappearing. It is thought that the leukemic stem cell (LSC) that initiates the disease perhaps goes into hiding when therapy drugs (Tyrosine Kinase Inhibitors - TKIs) are introduced into a patient's system. These "hiding" cells are referred to as Quiescent LSCs. In most cases, TKI therapy will keep the disease from progressing to an accelerated or blast phase, yet does not eliminate the LSCs.
Therapy is chronic and medications must be continued. It is critical that you take your medication as prescribed and do not miss doses unless advised to hold a dose by your hematologist/oncologist.
We are cautiously optimistic about finding a cure for CML. But a cure is not immediately available
I have had radiation therapy for a previous cancer. Do I have a higher risk for developing CML?
The occurrence of this is quite low but your health care team will ask you about previous radiation exposure when documenting your history. If they do not ask you, tell them so that they will have a complete picture of your medical history. There is some evidence that patients who have been diagnosed with other cancers and have received radiation therapy have a greater incidence of Chronic Myeloid Leukemia (CML). High levels of radiation exposure such as those experienced by individuals during World War II, have been associated with an increase in risk of developing several different types of cancers and conditions.
Does exposure to chemicals raise your risk of developing CML?
There are conflicting views on whether Benzene exposure increases a person's susceptibility to development of CML. There is a confirmed connection between Benzene exposure and Acute Myelogenous Leuemia (AML), however, research has been inconclusive on the connection between Benzene and CML.
Does having CML make me more likely to develop other types of cancer?
There has been no conclusive evidence that CML causes one to be more susceptible to develop other cancers. An important study undertaken at MD Anderson, which looked at secondary cancer development in patients with CML and myeloproliferative neoplasms being treated with Tyrosine Kinase Inhibitors (TKIs), concluded the following:
In conclusion, second cancers occur in a small percentage of patients receiving therapy with TKIs for hematologic malignancies, mostly CML. Analyzed in the context of the underlying lifetime risk of developing cancer by the general population and in patients who survive cancer, no evidence at the moment suggests that exposure to TKIs is carcinogenic. Continued long-term monitoring of these patients and reporting of any patients who develop second cancers are warranted to further define any possible longer-term risks.*
There are a number of epidemiological studies in progress that are analyzing both the incidence and prevalence of different cancers in families, geographic regions, cultures, occupations, etc. It will be interesting to learn of their results as they become available. Stay in touch with new research findings on the National CML Society's website and facebook page.
see the US National Library of Medicine link HERE.