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What is the difference between CML (chronic myelogenous leukemia) become AML (acute myelogenous leukemia) and CMMoL (chronic myelomonocytic leukemia)?

What is the difference between CML (chronic myelogenous leukemia) become AML (acute myelogenous leukemia) and CMMoL (chronic myelomonocytic leukemia)?

Question

Dear OncoLink "Ask The Experts,"

My mother has been diagnosed with CML, however, due to a "negative" result of the Philadelphia chromosome, the doctors are having her examined for chronic myelo-monocytic leukemia. What are the risks for her CML to become AML?

Thank you for your response.  


Answer

Selina M. Luger, MD, Director of the Leukemia Program and Assistant Professor of Medicine at the University of Pennsylvania, responds:

The three diseases you mention are 3 distinct entities.

CML or chronic myelogenous leukemia is a disease in which patients have too many mature white blood cells. It is considered a myeloproliferative disorder-a condition in which the bone marrow makes too many cells. This disease is diagnosed by the presence of either the Philadelphia Chromosome or the gene made by the Philadelphia chromosome, called bcr-abl. New treatments, which target this abnormal gene, have been developed. It is considered in the list of possible diagnoses, this chromosome is looked for so that appropriate therapy is not missed.

AML or acute myelogenous leukemia is a disease in which patients have too many immature white blood cells in their bone marrow that are not capable of maturing properly. These immature cells act very rapidly and can cause life-threatening problems if the disease is not treated promptly.

CMMoL or chronic myelomonocytic leukemia is a disorder of the bone marrow where the bone marrow is making too many white blood cells called monocytes. The bone marrow appears myeloproliferative but the cells that it makes are not normal mature cells and do not function properly. This disorder is called a myelodysplatic disorder (funny looking bone marrow). Its progression and outcome is variable and can be predicted to some degree by the blood counts and bone marrow findings.