What is Chronic Myeloid Leukaemia?
Chronic Myeloid Leukaemia (CML) is a rare type of blood cancer in children. It develops in the bone marrow when white blood cells grow and multiply in an uncontrolled way. Unlike acute leukaemias, CML often develops more slowly and may be found during routine blood tests before symptoms appear.
CML is linked to a specific genetic change called the Philadelphia chromosome, which helps guide treatment.
Signs & Symptoms
Symptoms may include:
- tiredness
- pale skin
- tummy discomfort due to an enlarged spleen
- frequent infections
- bruising or bleeding
- bone or joint aches
- weight loss or reduced appetite
These symptoms can also be caused by many common illnesses and do not necessarily mean cancer.
How is it Diagnosed?
If CML is suspected, your child will be referred urgently to a specialist centre. Tests may include:
- blood tests – showing high numbers of white blood cells
- bone marrow test – to confirm the diagnosis
- genetic testing – to detect the Philadelphia chromosome (BCR-ABL gene)
- ultrasound – to check spleen size
These results help identify CML and guide treatment decisions.
Treatment
Treatment for CML is different from treatment for acute leukaemias and focuses on medicines that target the genetic change driving the cancer.
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Targeted Therapy (TKIs)
Most children with CML are treated with medicines called tyrosine kinase inhibitors (TKIs). These block the abnormal BCR-ABL protein that causes cells to grow uncontrollably. TKIs are usually taken as tablets at home and can control the disease very effectively. -
Chemotherapy
Sometimes used to reduce very high white blood cell counts before starting targeted therapy. -
Stem Cell Transplant
A transplant may be considered if TKIs do not work well enough, if the disease progresses, or if genetic testing shows treatment-resistant changes.
Supportive Care
Your child may receive:
- medicines to manage side effects of TKIs
- transfusions if needed
- infection prevention and monitoring
- psychological and play support
- help with school and daily routines
Monitoring Response
Regular blood tests and molecular tests (PCR for BCR-ABL) are used to track how well treatment is working. Many children achieve deep molecular remission with TKIs.
Outlook & Support
Children with CML often do very well on targeted therapy, with many achieving excellent long-term control of the disease.
During treatment your child will be cared for by a specialist children’s cancer team. Help is available with managing side effects, school, emotional wellbeing and practical concerns.
Lennox Children’s Cancer Fund will support your whole family from diagnosis, through treatment and beyond.
Key Facts
- Common Age: Very rare in children; more common in teenagers if it occurs
- Survival: Excellent long-term survival with modern targeted therapy
- How common? CML accounts for less than 5% of childhood leukaemias
