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Chronic myeloid leukemia (CML) is a rare type of blood cancer that develops in the bone marrow when immature white blood cells, called myeloid cells, begin to grow and multiply at an abnormal rate. These abnormal cells crowd out healthy blood cells, leading to anemia, infection risk and bleeding problems. CML is strongly linked to a specific genetic change known as the Philadelphia chromosome, which leads to the production of an abnormal protein that drives uncontrolled cell growth. CML most commonly affects adults and is rare in children, accounting for about 3% of childhood leukemia cases. When it does occur in children, careful diagnosis and specialized treatment are essential. CML progresses through three phases: Chronic phase – early stage, usually mild symptoms Accelerated phase – disease becomes more aggressive Blast (acute) phase – behaves like acute leukemia and is life-threatening Pediatric CML Signs and Symptoms CML in children can vary widely. Some children have clear symptoms, while others may be diagnosed during routine blood tests. Common symptoms include: Persistent fatigue and weakness Easy bruising or bleeding, even after minor injuries Bone pain, especially in the legs and long bones Night sweats and chills Unexplained weight loss Abdominal pain or fullness (often due to enlarged spleen) Pale skin caused by anemia Persistent or recurrent fever These symptoms are not specific to CML, so proper medical evaluation is always required. Pediatric CML Diagnosis To confirm CML, doctors use several tests: Blood Tests Complete Blood Count (CBC): High white blood cell count, low red blood cells and platelets Peripheral Blood Smear: Detects immature cells (blasts) and abnormal blood cell shapes Bone Marrow Aspiration and Biopsy Samples of liquid and solid bone marrow are examined to identify leukemia cells and assess disease phase. Flow Cytometry Uses laser technology to analyze leukemia cells in detail, helping confirm the diagnosis. Imaging Tests Used to assess organ involvement: CT scan: Detects enlarged spleen, liver or lymph nodes MRI: Evaluates organs, bones and tissues Ultrasound: Checks spleen, liver, kidneys and sometimes brain involvement Pediatric CML Treatment Options Treatment depends on disease phase, response to therapy and overall health. Targeted Therapy (First-Line Treatment) Uses tyrosine kinase inhibitors (TKIs) Targets the genetic abnormality caused by the Philadelphia chromosome Highly effective and often allows long-term disease control Chemotherapy Used less commonly as a stand-alone treatment May be combined with targeted therapy Often used before a bone marrow transplant Bone Marrow (Stem Cell) Transplant Considered when targeted therapy fails or disease is advanced Replaces diseased marrow with healthy stem cells Offers the only potential cure, but carries higher risks Key Takeaway Although pediatric CML is rare, modern targeted therapies have transformed outcomes, allowing many children to live normal, active lives. Early diagnosis, close monitoring and treatment at specialized centers are critical for the best results.

What Is Chronic Lymphocytic Leukemia (CLL)? Chronic lymphocytic leukemia (CLL) is a type of blood cancer that affects the bone marrow and blood. In a healthy body, blood stem cells mature into red blood cells, platelets, and white blood cells (lymphocytes) that help fight infection. In CLL, too many blood stem cells develop into abnormal lymphocytes, also called leukemia cells. These cells do not function properly and cannot fight infections effectively. As they accumulate in the bone marrow and bloodstream, they crowd out healthy blood cells. This can lead to anemia, increased risk of infections, and easy bruising or bleeding. CLL is considered a chronic leukemia, meaning it usually progresses slowly over time. Risk Factors for CLL The main risk factors associated with CLL include: Family history of CLL Family history of cancers of the lymphatic system Age over 70 Male sex White ethnicity Exposure to Agent Orange CLL does not appear to be linked to diet, infections, or smoking. Symptoms of CLL CLL often develops silently. Many people have the disease for years without symptoms and are diagnosed incidentally during routine blood tests for unrelated conditions. When symptoms do appear, they may include: Fatigue and weakness Enlarged lymph nodes (felt as painless lumps under the skin) Abdominal discomfort or a feeling of fullness due to an enlarged spleen Unexplained weight loss Night sweats Frequent or severe infections Types of CLL There are two main biological forms of CLL: Slow-growing (indolent) CLL, which may not require treatment for many years Faster-growing (aggressive) CLL, which progresses more rapidly and requires earlier treatment The difference between these types cannot be determined by symptoms alone. Specialized laboratory and genetic testing are required to identify the form of CLL and guide treatment decisions.