Chronic Myeloid Leukemia

Chronic myeloid leukemia (CML) is a slow progressive blood cancer. The symptoms are fast bleeding, fatigue, fever, weight loss, loss of appetite, pale skin, and night sweats. Targeted drugs (Imatinib, Dasatinib), blood stem cell transplant, chemotherapy, and biological therapy are used in the treatment.

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What are the risk factors associated with CML?

Query: Hi doctor, My niece's boyfriend was diagnosed with CML three months back with BCR-ABL positive. He is now stable and is taking Imatinib 400 mg daily. Earlier she was considering engaging with the boy for marriage. Now she wants to know the risk factors she has to face if she goes ahead with the wed...  Read Full »

Dr. Abdul Aziz Khan

Answer: Hi, Welcome to I had gone through the reports attached (attachments removed to protect the patient's identity). CML (chronic myelogenous leukemia) is a chronic disease that is compatible for long survival with current targeted therapy, like tablet Imatinib, but it is difficult to ...  Read Full »

Do increased levels of RBC and vitamin B12 cause polycythemia vera?

Query: Hi doctor, My RBC levels have been slightly elevated for the past six months. It was 5.17 a year back, and a couple of months back it was 5.39. I noticed that from the last two years, the RBC count has been borderline high. Last week my vitamin B12 was tested due to a nerve issue in my face, which ...  Read Full »

Dr. Parth R Goswami

Answer: Hi, Welcome to I appreciate your knowledge and awareness towards your health, and I have seen your reports (attachment removed to protect patient identity). Your vitamin B12 level is certainly high, enough that warrants further investigation. Following are the common causes for high vit...  Read Full »

Kindly suggest the condition of the patient on seeing the investigations attached.

Query: Hi doctor, The patient was admitted due to eight episodes of hematemesis, weight loss and loss of appetite since last six months. It was accompanied by bone pain, abdominal pain, abdominal distension, jaundice, vomiting, altered bowel habit, fever, shortness of breath, decrease urine output or al...  Read Full »

Dr. Parth R Goswami

Answer: Hi, Welcome to I had undergone the patient's reports (attachment removed to protect patient identity). First of all, the patient has a tear in esophageal mucosa because of which bleeding occurred. To prevent bleeding, I suggest vasoconstrictor agent, adrenaline injection in the mucos...  Read Full »

Does the presence of JAK2 gene mutation automatically rule out CML?

Query: Hi doctor, My platelet has always been high in the range of 600 to 700 x 10"9/L. My other blood count is within the normal range as of today. Ten years ago, I had two BCR or ABL test (peripheral blood) to rule out CML; one test came back positive, the other negative. Which test should I believe? Th...  Read Full »

Dr. Parth R Goswami

Answer: Hello, Welcome to I can understand your concern. Do not worry. I will try to answer all of your questions. Following is my answers and opinion to your questions. RT PCR (Reverse transcriptase-polymerase chain reaction) is a highly accurate test to check BCR ABL mutation to rule out...  Read Full »

What are the tests done to check blood cell levels?

Query: Hi doctor, I am a 35 year old female. I have hypothyroidism and I am on Synthyroid. Overall, I am healthy. I exercise daily and do not smoke. I have a 15 month old toddler. Throughout my pregnancy, my blood work showed an elevated WBC, but they are under 15 k/mL. They just assumed it was due to bein...  Read Full »

Dr. Prakash H Muddegowda

Answer: Hi, Welcome to Based on your query, my opinion is as follows: The high basophil count of 10% associated with immature granulocytes of 9.8% is a bit worrisome. The white blood cell count is unusually low for the above findings. As with the above, I expect to usually count on more than 10...  Read Full »

I am under treatment for chronic myeloid leukemia. Please give your opinion on my report.

Query: Hello doctor, I need an opinion on BCR-ABL quantitative report. I am on Imatinib for chronic myeloid leukemia.  Read Full »

Dr. Parth R Goswami

Answer: Hello, Welcome to There are no abnormal premature cells in CBC in the attached report (attachment removed to protect patient identity). So I presume that the hematological response is very good. However, I suggest further investigating the peripheral smear examination report to ...  Read Full »

Is skin whitening side effect of Gleevec permanent?

Query: Hi doctor, I have CML-CP. I am on Gleevec for the last one year. My query is about the skin whitening as it has turned too white. Will this side effect go away?  Read Full »

Dr. Prasad Eswaran

Answer: Hi, Welcome to Skin whitening is technically called hypopigmentation. This is the usual side effect of Gleevec (Imatinib) and usually harmless. Usually, it is reversible once the drug is stopped. However, evidences for stopping the drug are limited and no consensus exists on drug cessat...  Read Full »

Does high mean platelet volume indicate a type of blood cancer?

Query: Hello doctor, I just had my routine medical check-up. And I got my CBC report. My platelet count is 210000 and in range but my MPV (mean platelet volume) is 12.8. Is it anything to really worry about?  Read Full »

Dr. Parth R Goswami

Answer: Hello, Welcome to You need not to worry about your platelet count and MPV. In your attached report, total WBC (white blood cells) count is borderline low and lymphocyte count is borderline high. So it could be a temporary viral infection. You can repeat your CBC (complete blood count...  Read Full »

Why would I be BCR-ABL positive and Philadelphia chromosome negative?

Query: Hello doctor, Can you please explain why I would have the gene and not the chromosome? Ph-negative, BCR-ABL-positive CML. The labs pointed to this. I had bone marrow aspiration and biopsy. I saw the doctor again. From all the labs, it looks like there is CD4 and CD8 elevated ratio 16.5, 8 % NK...  Read Full »

Dr. Smrita Singh

Answer: Hello, Welcome to Chronic myeloid leukemia (CML) is a hematopoietic disorder, almost always characterized by the presence of the Philadelphia chromosome (Ph), usually due to t(9;22)(q34;q11) or its variants. The Ph results in the formation of the BCR/ABL1 fusion gene, which ...  Read Full »

Do I really have chronic myeloid leukemia?

Query: Hello doctor, I am 18 years old and I got told that I had chronic myeloid leukemia. Do I seriously have it? Or what do I really have? Blood test: high basophils and low hemoglobin. My symptoms are weight loss, anemia, dizziness and pale skin. Urine: leukocytes 1 to 2. And, I have a ball right under...  Read Full »

Dr. Rahul Rathee

Answer: Hello, Welcome to Well, CML (chronic myeloid leukemia) is a treatable blood cancer. The diagnosis of CML is suspected by a peripheral blood examination in which the number of basophils and eosinophils is highly raised and urine examination has no role in its diagnosis. So, on the basi...  Read Full »

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