CMML is an unusual type of blood cancer. It is also called myelodysplastic/myeloproliferative neoplasm (MPN). This cancer affects the white blood cells that fight infection and the platelets that cause clotting. In CMML, your bone marrow produces abnormal monocytes and immature blood cells called blasts. These cells grow and spill out into the bloodstream, where they damage healthy blood cells and cause symptoms.
Your doctor can diagnose CMML by taking a sample of your blood and examining it under a microscope. Your doctor may also do a bone marrow aspiration or biopsy. These procedures involve inserting a thin needle into the bone marrow to take out small samples of cells for further testing. These procedures can cause serious side effects, such as infection, bleeding problems and lowered blood counts.
If you are diagnosed with CMML, your doctor will classify your disease risk according to WHO criteria and one of the established scoring systems. This is important because a minority of patients develops transformation into acute myeloid leukemia.
Most people with CMML have mutations in genes that control the development of normal blood cells. These mutations can be caused by exposure to certain chemicals or by radiation. CMML can also be caused by genetic changes that happen as you get older. These changes are not a direct cause of CMML but can make it more likely to develop.
The most common treatment for CMML involves medications that block the growth of cancerous cells. These medications are called tyrosine kinase inhibitors, or TKIs. Examples of these medicines are imatinib and azacitidine. Other treatments used to treat CMML include chemotherapy, stem cell transplant and other types of therapy.
People with CMML have a higher risk of developing a cancer called acute myeloid leukemia (AML) than people with other types of MPN. AML occurs when the number of blast cells in your blood increases to more than 20%.
AML is a more serious type of leukemia and requires different treatment than CMML. People with AML have a much lower chance of getting better or surviving longer than people with CMML.
If you have a high risk of developing AML, your doctor might recommend a stem cell transplant. This procedure is the only potentially curative treatment for CMML, but it can be very hard on you. It’s best to have the transplant at a center that has experience treating leukemia and other blood cancers. You might be able to participate in a clinical trial, or research study, that tests promising new treatments for CMML. Ask your doctor about these trials. He or she can explain what they are and help you find the right ones for you.
