Materiały źródłowe

• #1 Chronic Myeloid Leukemia, from Pathophysiology to Treatment-Free Remission: A Narrative Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10084831/

  Chronic myeloid leukemia (CML) is a hematopoietic stem cell (HSC) disorder, as are all leukemias. In CML, the disorder is characterized by translocation t(9;22)(q34;q11), resulting in the fusion of BCR and ABL1 genes into the pathogenic BCR-ABL1 oncogene, with many subsequent effects on downstream pathways. The main pathway effect of this fused oncogene is to activate tyrosine kinase pathway constitutively, resulting in a proliferative advantage of the mutant HSCs compared to normal HSCs, and the gradual displacement of normal HSCs. […] The presence of BCR-ABL1 fusion gene in hematopoietic stem cells has been shown to be sufficient for initiation of CML. Thus, the pathophysiology of CML revolves around the BCR-ABL1 fusion gene. Approximately 90% to 95% of patients with CML have reciprocal translocation of t(9;22) (q34;q11.2). This results in a shortened chromosome 22, termed Philadelphia chromosome, containing the BCR-ABL1 oncogene.

• #2 Chronic Myelogenous Leukemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK531459/

  Chronic myelogenous leukemia (CML), BCR-ABL1-positive, is classified as a myeloproliferative neoplasm predominantly composed of proliferating granulocytes and determined to have the Philadelphia chromosome/translocation t(9;22)(q34;q11.2). CML affects both the peripheral blood and the bone marrow. There is an increased incidence of CML among atomic bomb survivors; however, the predisposing risk factors are unknown. […] There is an increased incidence of CML among atomic bomb survivors; however, the predisposing risk factors are unknown.[1]

• #3 Chronic myelogenous leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_myelogenous_leukemia

  In most cases, no obvious cause for CML can be isolated. […] Exposure to ionising radiation appears to be a risk factor, based on a 50 fold higher incidence of CML in Hiroshima and Nagasaki nuclear bombing survivors. […] CML was the first cancer to be linked to a clear genetic abnormality, the chromosomal translocation known as the Philadelphia chromosome. […] The action of the BCR-ABL protein is the pathophysiologic cause of chronic myelogenous leukemia. […] With improved understanding of the nature of the BCR-ABL protein and its action as a tyrosine kinase, targeted therapies (the first of which was imatinib) that specifically inhibit the activity of the BCR-ABL protein have been developed. […] These tyrosine kinase inhibitors can induce complete remissions in CML, confirming the central importance of bcr-abl as the cause of CML.

• #4 Chronic Myeloid Leukemia (CML) – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/chronic-myeloid-leukemia-cml

  Chronic myeloid leukemia (CML) occurs when a pluripotent stem cell undergoes malignant transformation and clonal myeloproliferation, leading to a striking overproduction of mature and immature granulocytes. […] The Philadelphia (Ph) chromosome is present in 90 to 95% of cases of chronic myeloid leukemia. The Ph chromosome is the product of a reciprocal translocation between chromosomes 9 and chromosome 22, t(9;22). During this translocation, a piece of chromosome 9 containing the oncogene ABL is translocated to chromosome 22 and fused to the BCR gene. The chimeric fusion gene BCR-ABL is responsible for production of the oncoprotein bcr-abl tyrosine kinase. […] CML ensues when an abnormal pluripotent hematopoietic progenitor cell initiates excessive production of all myeloid lineage cells, primarily in the bone marrow but also in extramedullary sites (eg, spleen, liver). […] Tyrosine kinase inhibitors inhibit the BCR-ABL oncogene, which is responsible for induction of CML. […] Chronic myeloid leukemia (CML) involves a chromosomal translocation that creates the Philadelphia chromosome, t(9;22).

• #5 Chronic myelogenous leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_myelogenous_leukemia

  In most cases, no obvious cause for CML can be isolated. […] Exposure to ionising radiation appears to be a risk factor, based on a 50 fold higher incidence of CML in Hiroshima and Nagasaki nuclear bombing survivors. […] CML was the first cancer to be linked to a clear genetic abnormality, the chromosomal translocation known as the Philadelphia chromosome. […] The action of the BCR-ABL protein is the pathophysiologic cause of chronic myelogenous leukemia. […] With improved understanding of the nature of the BCR-ABL protein and its action as a tyrosine kinase, targeted therapies (the first of which was imatinib) that specifically inhibit the activity of the BCR-ABL protein have been developed. […] These tyrosine kinase inhibitors can induce complete remissions in CML, confirming the central importance of bcr-abl as the cause of CML.

• #6 What Causes Chronic Myeloid Leukemia? | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/causes-risks-prevention/what-causes.html

  Normal human cells grow and function based mainly on the information contained in each cell’s chromosomes. […] Over the past few years, scientists have made great progress in understanding how certain changes in DNA can cause normal bone marrow cells to become leukemia cells. In no cancer is this better understood than in chronic myeloid leukemia (CML). […] Most cases of CML start during cell division, when DNA is „swapped” between chromosomes 9 and 22. […] This is known as a translocation and it makes a chromosome 22 that’s shorter than normal. This new abnormal chromosome is called the Philadelphia chromosome. The Philadelphia chromosome is found in the leukemia cells of almost all patients with CML. […] The swapping of DNA between the chromosomes leads to the formation of a new gene (an oncogene) called BCR-ABL. This gene then produces the BCR-ABL protein, which is the type of protein called a tyrosine kinase. This protein causes CML cells to grow and divide out of control. […] Sometimes people inherit DNA mutations from a parent that greatly increase their risk of getting certain types of cancer. But mutations passed on by parents do not cause CML. DNA changes related to CML occur during the person’s lifetime, rather than having been inherited before birth.

• #7 Chronic myelogenous leukemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-myelogenous-leukemia/symptoms-causes/syc-20352417

  Most people with chronic myelogenous leukemia have a chromosome called the Philadelphia chromosome inside their blood cells. […] Chronic myelogenous leukemia happens when something causes changes to the bone marrow cells. It’s not clear what starts this process. […] The Philadelphia chromosome forms when chromosome 9 and chromosome 22 break and exchange parts. This creates a short chromosome 22 and a new combination of instructions for the cells. These new instructions can lead to the development of chronic myelogenous leukemia. […] Genes from chromosome 9 combine with genes from chromosome 22 to create a new gene called BCR-ABL. The BCR-ABL gene tells the blood cells to produce too much of a protein called tyrosine kinase. Tyrosine kinase promotes cancer by allowing certain blood cells to grow out of control.

• #8 Chronic Myeloid Leukemia (CML) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/chronic-myeloid-leukemia-cml

  Some non-inherited genetic abnormalities put people at risk for certain diseases, including chronic myeloid leukemia, a type of blood cancer. […] A genetic abnormality that occurs during a persons lifetime (rather than one that has been inherited from a parent) causes chronic myeloid leukemia. Its not possible to pass this abnormality along to children. […] When a person develops chronic myeloid leukemia, two chromosomeschromosome 9 and chromosome 22swap some of their genetic information with each other during division of blood-forming cells. […] When chromosome 22 mutates this way, its known as a Philadelphia chromosome. Its presence confirms chronic myeloid leukemia. […] When chromosomes 9 and 22 exchange genetic material, it leads to the creation of a new gene, called BCR-ABL. This gene produces a tyrosine kinase protein that promotes uncontrolled growth of the granulocytes.

• #9 Chronic Myeloid Leukemia, from Pathophysiology to Treatment-Free Remission: A Narrative Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10084831/

  Chronic myeloid leukemia (CML) is a hematopoietic stem cell (HSC) disorder, as are all leukemias. In CML, the disorder is characterized by translocation t(9;22)(q34;q11), resulting in the fusion of BCR and ABL1 genes into the pathogenic BCR-ABL1 oncogene, with many subsequent effects on downstream pathways. The main pathway effect of this fused oncogene is to activate tyrosine kinase pathway constitutively, resulting in a proliferative advantage of the mutant HSCs compared to normal HSCs, and the gradual displacement of normal HSCs. […] The presence of BCR-ABL1 fusion gene in hematopoietic stem cells has been shown to be sufficient for initiation of CML. Thus, the pathophysiology of CML revolves around the BCR-ABL1 fusion gene. Approximately 90% to 95% of patients with CML have reciprocal translocation of t(9;22) (q34;q11.2). This results in a shortened chromosome 22, termed Philadelphia chromosome, containing the BCR-ABL1 oncogene.

• #10 Chronic Myeloid Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/cml-treatment-pdq

  Chronic myeloid leukemia is a disease in which the bone marrow makes too many white blood cells. […] Most people with chronic myeloid leukemia have a gene mutation (change) called the Philadelphia (Ph) chromosome. […] In CML, too many myeloblasts (a type of immature white blood cell) form in the blood and bone marrow, and the disease worsens as the number of myeloblasts increases. […] The Philadelphia (Ph) chromosome is an abnormal chromosome that is made when pieces of chromosomes 9 and 22 break off and trade places. […] Changes in certain chromosomes, such as the Philadelphia chromosome, may be a sign of cancer.

• #11 Chronic Myeloid Leukaemia (Causes, Symptoms and Treatment)

  https://patient.info/doctor/chronic-myeloid-leukaemia-pro

  Chronic myeloid leukaemia (CML) is a myeloproliferative disorder of pluripotent haemopoietic stem cells, affecting one or all cell lines (erythroid, platelet and myeloid). Over time, the leukaemic cells proliferate due to stepped-up production and failed apoptosis. More than 90% of cases of CML result from a cytogenetic aberration known as the Philadelphia chromosome. […] The initiating event or events are unknown: there are no known hereditary, familial, geographic, ethnic or economic associations. There may be an increased risk after exposure to the atomic bombs dropped on Hiroshima and Nagasaki but not with lower levels of radiation. […] CML is characterised by a consistent cytogenetic abnormality – a reciprocal translocation between the long arms of chromosomes 22 and 9, t(9;22). The result is a shortened chromosome 22, known as the Ph chromosome. The translocation is significant because it places an oncogene (abl) from the long arm of chromosome 9 to the long arm of chromosome 22 in the BCR region. The BCR-ABL fusion gene encodes a chimeric protein with strong tyrosine kinase activity. This constitutively active BCR-ABL tyrosine kinase causes CML but how the presence of this oncoprotein leads to the CML phenotype is not fully understood. […] CML’s hallmark is the presence of BCR-ABL rearrangement and is considered diagnostic when present in a patient with clinical manifestations of CML.

• #12 Chronic Myeloid Leukemia Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/leukemia/hp/cml-treatment-pdq

  CML is a clonal disorder that is easily diagnosed because the leukemic cells of more than 95% of patients have a distinctive cytogenetic abnormality, the Philadelphia chromosome (Ph). […] The Ph chromosome results from a reciprocal translocation between the long arms of chromosomes 9 and 22, and it is demonstrable in all hematopoietic precursors. […] This translocation results in the transfer of the ABL1 oncogene on chromosome 9 to an area of chromosome 22 termed the breakpoint cluster region (within the BCR gene). […] This, in turn, results in a BCR::ABL1 fusion gene and in the production of an abnormal tyrosine kinase protein that causes the disordered myelopoiesis found in CML. […] Risk factors for CML include: Older age. […] Exposure to high-dose ionizing radiation.

• #13 Chronic Myelogenous Leukemia (CML): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/199425-overview

  CML is one of the few cancers known to be caused by a single, specific genetic mutation. More than 90% of cases result from a cytogenetic aberration known as the Philadelphia chromosome (see Pathophysiology). […] The initiating factor of CML is still unknown, but exposure to ionizing radiation has been implicated, as observed in the increased prevalence among survivors of the atomic bombing of Hiroshima and Nagasaki. Other agents, such as benzene, are possible causes.

• #14 Chronic myelogenous leukemia | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/chronic-myelogenous-leukemia?content_id=CON-20167627

  Most people with chronic myelogenous leukemia have a chromosome called the Philadelphia chromosome inside their blood cells. […] Chronic myelogenous leukemia happens when something causes changes to the bone marrow cells. It’s not clear what starts this process. However, doctors have discovered how it progresses into chronic myelogenous leukemia. […] The Philadelphia chromosome creates a new gene called BCR-ABL. The BCR-ABL gene tells the blood cells to produce too much of a protein called tyrosine kinase. Tyrosine kinase promotes cancer by allowing certain blood cells to grow out of control. […] In chronic myelogenous leukemia, this process doesn’t work properly. The tyrosine kinase allows too many white blood cells to grow. Most or all of these cells contain the Philadelphia chromosome. The diseased white blood cells don’t grow and die like they should. The diseased white blood cells build up in huge numbers. They crowd out healthy blood cells and damage the bone marrow. […] Factors that increase the risk of chronic myelogenous leukemia include older age, being male, and radiation exposure. […] The gene change that leads to chronic myelogenous leukemia isn’t passed from parents to children. This change is believed to develop after birth.

• #15 Chronic Myeloid Leukemia, from Pathophysiology to Treatment-Free Remission: A Narrative Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10084831/

  Chronic myeloid leukemia (CML) is a hematopoietic stem cell (HSC) disorder, as are all leukemias. In CML, the disorder is characterized by translocation t(9;22)(q34;q11), resulting in the fusion of BCR and ABL1 genes into the pathogenic BCR-ABL1 oncogene, with many subsequent effects on downstream pathways. The main pathway effect of this fused oncogene is to activate tyrosine kinase pathway constitutively, resulting in a proliferative advantage of the mutant HSCs compared to normal HSCs, and the gradual displacement of normal HSCs. […] The presence of BCR-ABL1 fusion gene in hematopoietic stem cells has been shown to be sufficient for initiation of CML. Thus, the pathophysiology of CML revolves around the BCR-ABL1 fusion gene. Approximately 90% to 95% of patients with CML have reciprocal translocation of t(9;22) (q34;q11.2). This results in a shortened chromosome 22, termed Philadelphia chromosome, containing the BCR-ABL1 oncogene.

• #16 Chronic myelogenous leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_myelogenous_leukemia

  In most cases, no obvious cause for CML can be isolated. […] Exposure to ionising radiation appears to be a risk factor, based on a 50 fold higher incidence of CML in Hiroshima and Nagasaki nuclear bombing survivors. […] CML was the first cancer to be linked to a clear genetic abnormality, the chromosomal translocation known as the Philadelphia chromosome. […] The action of the BCR-ABL protein is the pathophysiologic cause of chronic myelogenous leukemia. […] With improved understanding of the nature of the BCR-ABL protein and its action as a tyrosine kinase, targeted therapies (the first of which was imatinib) that specifically inhibit the activity of the BCR-ABL protein have been developed. […] These tyrosine kinase inhibitors can induce complete remissions in CML, confirming the central importance of bcr-abl as the cause of CML.

• #17 Chronic Myelogenous Leukemia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/19535

  There is an increased incidence of CML among atomic bomb survivors; however, the predisposing risk factors are unknown.[1] […] The BCR-ABL1 oncoprotein acts as a constitutively active tyrosine kinase. The mainstay of treatment in CML is tyrosine kinase inhibitors. Risk stratification scores are useful in determining first-line therapy choices. […] The mutational analysis may be important in cases with resistance to tyrosine kinase inhibitor therapy. Ponatinib is a tyrosine kinase inhibitor especially useful for those with a T315I BCR-ABL1 mutation.

• #18 Chronic myelogenous leukemia | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/chronic-myelogenous-leukemia

  In chronic myelogenous leukemia, this process doesn’t work properly. The tyrosine kinase allows too many white blood cells to grow. Most or all of these cells contain the Philadelphia chromosome. The diseased white blood cells don’t grow and die like they should. The diseased white blood cells build up in huge numbers. They crowd out healthy blood cells and damage the bone marrow. […] Factors that increase the risk of chronic myelogenous leukemia include: Older age. CML is more common in older people than in children and teens. […] The gene change that leads to chronic myelogenous leukemia isn’t passed from parents to children. This change is believed to develop after birth.

• #19 Chronic Myeloid Leukemia (CML): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21845-chronic-myelogenous-leukemia-cml

  Chronic myeloid leukemia (CML) is blood cancer that starts in the blood-forming myeloid cells or stem cells in your bone marrow. […] People with CML have an acquired genetic mutation or change in myeloid stem cells growing in their bone marrow. Acquired mutations aren’t present at birth and aren’t something you can inherit. Acquired mutations happen during your lifetime. […] In genetic mutations, mutated or changed genes give cells new instructions on what to do. In this case, the mutation creates a new fused gene, BCR-ABL. The new gene triggers the following chain of events that lead to chronic myeloid leukemia: The BCR-ABL gene gives new instructions to myeloid stem cells. […] The only risk factor for CML is exposure to high levels of radiation and this applies to very few people. […] No, it can’t. Medical researchers know CML happens when a specific gene mutates, but they haven’t discovered why that mutation happens.

• #20 Risks and causes of chronic myeloid leukaemia (CML) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/chronic-myeloid-leukaemia-cml/risks-causes

  We dont know what causes most cases of chronic myeloid leukaemia (CML). But we do know that exposure to radiation can increase your risk of developing CML. […] Some studies show radiation can increase your risk of CML. Researchers found that atomic bomb survivors had an increased risk of leukaemia. There is a 20 year study of the workers who cleaned up after the Chernobyl nuclear power plant accident in 1986. It showed that even at low doses of radiation there is an increased risk of all types of leukaemia.

• #21 Risk Factors for Chronic Myeloid Leukemia | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/causes-risks-prevention/risk-factors.html

  A risk factor is something that affects a person’s chance of getting a disease such as cancer. […] The only risk factors for chronic myeloid leukemia (CML) are: […] Radiation exposure: Being exposed to high-dose radiation (such as being a survivor of an atomic bomb blast or nuclear reactor accident) increases the risk of getting CML […] Age: The risk of getting CML goes up with age […] Sex: In general, leukemia is more common in men than women. This includes CML that is slightly more common in males than in females. The reason for this is not clear. […] There are no other proven risk factors for CML. The risk of getting CML does not seem to be affected by smoking, diet, exposure to chemicals, or infections. And CML does not run in families.

• #22 Chronic Myelogenous Leukemia (CML): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/199425-overview

  CML is one of the few cancers known to be caused by a single, specific genetic mutation. More than 90% of cases result from a cytogenetic aberration known as the Philadelphia chromosome (see Pathophysiology). […] The initiating factor of CML is still unknown, but exposure to ionizing radiation has been implicated, as observed in the increased prevalence among survivors of the atomic bombing of Hiroshima and Nagasaki. Other agents, such as benzene, are possible causes.

• #23 Chronic Myeloid Leukemia (CML) – Blood Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/blood-disorders/leukemias/chronic-myeloid-leukemia-cml

  Chronic myeloid leukemia (CML) may affect people of any age and of either sex but is uncommon in children younger than 10 years. The disease most commonly develops in adults between the ages of 40 and 60. The cause usually is a rearrangement of two particular chromosomes (9 and 22) into what is called the Philadelphia chromosome. The Philadelphia chromosome produces an abnormal enzyme (tyrosine kinase), which is responsible for the abnormal growth pattern increased production of the white blood cells in CML. […] Additional gene abnormalities (called mutations) that make CML more resistant to treatment sometimes occur.

• #24 Chronic Myeloid Leukemia (CML): Symptoms, Causes, Stages & Treatment

  https://resources.healthgrades.com/right-care/leukemia/chronic-myeloid-leukemia

  There are only a few known risk factors for CML. CML is not inherited from parents. […] CML does not seem to be linked to smoking, chemical exposure, or heredity. […] Risk factors include: Age: CML risk increases with age and about half of people are 65 years of age or older at diagnosis. […] High-dose radiation exposure: Very high levels of radiation increase the risk of CML. […] Sex: CML is slightly more common in males than females for unknown reasons.

• #25 Risk Factors for Chronic Myeloid Leukemia | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/causes-risks-prevention/risk-factors.html

  A risk factor is something that affects a person’s chance of getting a disease such as cancer. […] The only risk factors for chronic myeloid leukemia (CML) are: […] Radiation exposure: Being exposed to high-dose radiation (such as being a survivor of an atomic bomb blast or nuclear reactor accident) increases the risk of getting CML […] Age: The risk of getting CML goes up with age […] Sex: In general, leukemia is more common in men than women. This includes CML that is slightly more common in males than in females. The reason for this is not clear. […] There are no other proven risk factors for CML. The risk of getting CML does not seem to be affected by smoking, diet, exposure to chemicals, or infections. And CML does not run in families.

• #26 Chronic myeloid leukemia | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/chronic-myeloid-leukemia

  Chronic myeloid leukemia (CML) occurs when something causes genetic changes in myeloid cells a type of white blood cell in the bone marrow. It’s unclear what triggers this process. But 90% of people with CML have a genetic change, called the Philadelphia chromosome, that leads to immature myeloid cells multiplying out of control. […] We dont know why some people get the gene mutation that causes CML. It’s not hereditary. Still, a few risk factors may increase your chances of getting CML, including: […] CML is slightly more common in men. […] More than half of CML cases develop in people who are 65 or older. […] In rare cases, patients who have been exposed to high doses of radiation develop CML. This amount is far beyond the level of radiation you receive from things like dental X-rays and mammograms.

• #27 Chronic myeloid leukaemia (CML) – Leukaemia Foundation

  https://www.leukaemia.org.au/blood-cancer/types-of-blood-cancer/leukaemia/chronic-myeloid-leukaemia/

  Chronic myeloid leukaemia (CML) is a type of cancer that affects the blood and bone marrow. […] We know that CML is not inherited (passed down from one generation to the next) or contagious. Like other types of leukaemia, CML is thought to arise from an acquired mutation (or change) in one or more of the genes that normally control the growth and development of blood cells. This change or changes will result in abnormal growth. […] Most people diagnosed with CML have a genetic abnormality in their blood cells called the Philadelphia (Ph) chromosome. The Ph-chromosome causes the production of an enzyme called tyrosine kinase which leads to CML. Why these mutations occur in the first place remains unknown but there are likely to be a number of factors involved. Research is going on all the time into possible causes of this damage and certain factors have been identified that may put some people at an increased risk. These include exposure to: radiation — very high doses of radiation, either accidentally (nuclear accident) or therapeutically (to treat other cancers) […] chemicals — exposure to industrial chemicals like benzene over a long period of time, or exposure to certain types of chemotherapy to treat other cancers.

• #28 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Chronic-Myelogenous-Leukemia-Risk-Factors.aspx

  Chronic myeloid leukaemia or CML often begins when there is a change in the structure of DNA that affects the regulation of growth and maturity of the stem cells that produce white blood cells, red blood cells and platelets. […] The cause or trigger that can lead to the mutation of the DNA and make it cancerous is still unknown. […] There is some evidence that long term exposure to the chemical benzene leads to an increased risk of chronic myeloid leukaemia. […] The risk of getting CML rises with age. […] Exposures to pesticides among agriculture workers, exposure to chemicals among rubber or plastic manufacture workers, cleaners, builders labourers, hairdressers etc. have all been studied as risk factors for developing CML.

• #29 Chronic Myelogenous Leukemia – LegalInfo.com

  https://www.legalinfo.com/content/benzene-exposure/chronic-myelogenous-leukemia.html

  Chronic myelogenous leukemia is a type of bone-marrow cancer. […] What are the causes of chronic myelogenous leukemia? When CML occurs, something in the development of blood cells changes. It has not been determined what causes the changes to occur. […] In addition to the presence of the Philadelphia chromosome in CML patients, there is the potential that exposure to high levels of radiation, as well as to the chemical benzene, can lead to a development of chronic myelogenous leukemia. […] Factors that may increase a person’s risk for developing chronic myelogenous leukemia include older age, being male, and exposure to radiation or benzene. […] While doctors are not sure what causes CML, it is known that benzene is a carcinogen and has been linked with bone marrow and blood diseases.

• #30 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Chronic-Myelogenous-Leukemia-Risk-Factors.aspx

  Chronic myeloid leukaemia or CML often begins when there is a change in the structure of DNA that affects the regulation of growth and maturity of the stem cells that produce white blood cells, red blood cells and platelets. […] The cause or trigger that can lead to the mutation of the DNA and make it cancerous is still unknown. […] There is some evidence that long term exposure to the chemical benzene leads to an increased risk of chronic myeloid leukaemia. […] The risk of getting CML rises with age. […] Exposures to pesticides among agriculture workers, exposure to chemicals among rubber or plastic manufacture workers, cleaners, builders labourers, hairdressers etc. have all been studied as risk factors for developing CML.

• #31 Chronic Myelogenous Leukaemia: Causes, Symptoms And Treatment

  https://www.netmeds.com/health-library/post/chronic-myelogenous-leukaemia-causes-symptoms-and-treatment?srsltid=AfmBOopJSlUgra6xx7VxJpQpBGRcCIPJrti94l3HXB9JBYjlQsHHJ0G7

  Certain causative factors that aggravate the risk of CML include: […] Long-term exposure to certain chemicals, like benzene, pesticides, detergents, or paint strippers, may increase the incidence of Chronic myeloid leukaemia. […] Previous Cancer Treatment: People who have been subjected to certain types of chemotherapy and radiation therapy in the past owing to some other types of cancer have an aggravated risk of developing CML. […] Certain genetic disorders, such as Neurofibromatosis type 1, Trisomy 8, Downs syndrome, or Li-Fraumeni syndrome makes one more susceptible to Chronic Myeloid Leukaemia. […] Smoking and consumption of tobacco in any form aggravates the chances of getting diagnosed with Chronic Myeloid Leukaemia.

• #32 Leukemia: Symptoms, Signs, Causes, Types & Treatment

  https://my.clevelandclinic.org/health/diseases/4365-leukemia

  Leukemia starts when the DNA of a single cell in your bone marrow changes (mutates) and cant develop and function normally. […] Leukemia starts when the DNA of a single cell in your bone marrow changes (mutates). DNA is the instruction code that tells a cell when to grow, how to develop and when to die. Because of the mutation, or coding error, leukemia cells keep multiplying. All cells arising from the original mutated cell also have the mutated DNA. […] Scientists dont know what causes these developing cells to mutate. Theyve been able to identify some common mutations that people diagnosed with different types of leukemia share. […] Previous cancer treatment. Past cancer treatments involving radiation or chemotherapy may increase the likelihood youll develop some types of leukemia.

• #33 Chronic Myeloid Leukemia, from Pathophysiology to Treatment-Free Remission: A Narrative Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10084831/

  According to a study by Wang et al, BCR-ABL-negative CML patients have a worse overall survival and have a higher risk of their leukemia transforming into acute myeloid leukemia. Without the presence of BCR-ABL, most TKIs are not indicated as a main treatment, which may be one of the factors contributing to a worse prognosis in BCR-ABL-negative CML patients. Gene mutations commonly found in BCR-ABL-negative CML include SETBP1, ASXL1, NRAS/KRAS, SRSF2, CSF3R, U2AF1, and many others. Some of these mutations may be used as potential targets for therapy in BCR-ABL-negative CML, but the evidence to support this is currently lacking.

• #34 Chronic Myeloid Leukemia (CML): Symptoms, Causes, Stages & Treatment

  https://resources.healthgrades.com/right-care/leukemia/chronic-myeloid-leukemia

  Chronic myeloid leukemia (CML) is a type of blood and bone marrow cancer. […] In almost all cases, CML is the result of an abnormal chromosome called the Philadelphia chromosome. It causes the bone marrow to make abnormal myeloid cells. […] CML starts in the myeloid stem cell, most often the myeloblast branch. […] In CML, almost all people with the disease have a specific abnormality called the Philadelphia chromosome. […] The Philadelphia chromosome is the result of a mutation called a translocation. It occurs when part of chromosome 9 breaks off and reattaches to chromosome 22. […] This swapping of parts makes a new gene called BCR-ABL fusion on chromosome 22. The instructions this gene gives the cell is to make a protein called tyrosine kinase. […] A very small number of CML patients do not have the Philadelphia chromosome.

• #35 Chronic Myeloid Leukemia, from Pathophysiology to Treatment-Free Remission: A Narrative Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10084831/

  According to a study by Wang et al, BCR-ABL-negative CML patients have a worse overall survival and have a higher risk of their leukemia transforming into acute myeloid leukemia. Without the presence of BCR-ABL, most TKIs are not indicated as a main treatment, which may be one of the factors contributing to a worse prognosis in BCR-ABL-negative CML patients. Gene mutations commonly found in BCR-ABL-negative CML include SETBP1, ASXL1, NRAS/KRAS, SRSF2, CSF3R, U2AF1, and many others. Some of these mutations may be used as potential targets for therapy in BCR-ABL-negative CML, but the evidence to support this is currently lacking.

• #36 Chronic Myeloid Leukemia, from Pathophysiology to Treatment-Free Remission: A Narrative Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10084831/

  At the time of writing, the mechanism of Philadelphia chromosome formation and the time from the formation of the chromosome to the occurrence of clinical symptoms of CML are still not known with certainty. […] Some experts believe that the Ph chromosome can be formed as a result of spontaneous random translocation. Supporting this is the fact that the BCR-ABL1 gene has also been observed in a small proportion of healthy individuals. This could also mean that not all BCR-ABL1 fusion genes develop into CML. Further studies are needed to elucidate the origins of the BCR-ABL1 gene; however, it will be very difficult to isolate the exact causes that contribute to the formation of the Philadelphia chromosome due to the relative rareness of the disease and issues with determining the onset of the disease, as it is initially asymptomatic.

• #37 Chronic Myeloid Leukemia, from Pathophysiology to Treatment-Free Remission: A Narrative Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10084831/

  At the time of writing, the mechanism of Philadelphia chromosome formation and the time from the formation of the chromosome to the occurrence of clinical symptoms of CML are still not known with certainty. […] Some experts believe that the Ph chromosome can be formed as a result of spontaneous random translocation. Supporting this is the fact that the BCR-ABL1 gene has also been observed in a small proportion of healthy individuals. This could also mean that not all BCR-ABL1 fusion genes develop into CML. Further studies are needed to elucidate the origins of the BCR-ABL1 gene; however, it will be very difficult to isolate the exact causes that contribute to the formation of the Philadelphia chromosome due to the relative rareness of the disease and issues with determining the onset of the disease, as it is initially asymptomatic.

• #38 Chronic Myeloid Leukemia, from Pathophysiology to Treatment-Free Remission: A Narrative Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10084831/

  At the time of writing, the mechanism of Philadelphia chromosome formation and the time from the formation of the chromosome to the occurrence of clinical symptoms of CML are still not known with certainty. […] Some experts believe that the Ph chromosome can be formed as a result of spontaneous random translocation. Supporting this is the fact that the BCR-ABL1 gene has also been observed in a small proportion of healthy individuals. This could also mean that not all BCR-ABL1 fusion genes develop into CML. Further studies are needed to elucidate the origins of the BCR-ABL1 gene; however, it will be very difficult to isolate the exact causes that contribute to the formation of the Philadelphia chromosome due to the relative rareness of the disease and issues with determining the onset of the disease, as it is initially asymptomatic.

• #39 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Chronic-Myelogenous-Leukemia-Risk-Factors.aspx

  Chronic myeloid leukaemia or CML often begins when there is a change in the structure of DNA that affects the regulation of growth and maturity of the stem cells that produce white blood cells, red blood cells and platelets. […] The cause or trigger that can lead to the mutation of the DNA and make it cancerous is still unknown. […] There is some evidence that long term exposure to the chemical benzene leads to an increased risk of chronic myeloid leukaemia. […] The risk of getting CML rises with age. […] Exposures to pesticides among agriculture workers, exposure to chemicals among rubber or plastic manufacture workers, cleaners, builders labourers, hairdressers etc. have all been studied as risk factors for developing CML.

• #40 Chronic Myeloid Leukemia (CML) – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/chronic-myeloid-leukemia-cml

  Chronic myeloid leukemia (CML) occurs when a pluripotent stem cell undergoes malignant transformation and clonal myeloproliferation, leading to a striking overproduction of mature and immature granulocytes. […] The Philadelphia (Ph) chromosome is present in 90 to 95% of cases of chronic myeloid leukemia. The Ph chromosome is the product of a reciprocal translocation between chromosomes 9 and chromosome 22, t(9;22). During this translocation, a piece of chromosome 9 containing the oncogene ABL is translocated to chromosome 22 and fused to the BCR gene. The chimeric fusion gene BCR-ABL is responsible for production of the oncoprotein bcr-abl tyrosine kinase. […] CML ensues when an abnormal pluripotent hematopoietic progenitor cell initiates excessive production of all myeloid lineage cells, primarily in the bone marrow but also in extramedullary sites (eg, spleen, liver). […] Tyrosine kinase inhibitors inhibit the BCR-ABL oncogene, which is responsible for induction of CML. […] Chronic myeloid leukemia (CML) involves a chromosomal translocation that creates the Philadelphia chromosome, t(9;22).

• #41 Chronic Myeloid Leukemia Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/leukemia/hp/cml-treatment-pdq

  CML is a clonal disorder that is easily diagnosed because the leukemic cells of more than 95% of patients have a distinctive cytogenetic abnormality, the Philadelphia chromosome (Ph). […] The Ph chromosome results from a reciprocal translocation between the long arms of chromosomes 9 and 22, and it is demonstrable in all hematopoietic precursors. […] This translocation results in the transfer of the ABL1 oncogene on chromosome 9 to an area of chromosome 22 termed the breakpoint cluster region (within the BCR gene). […] This, in turn, results in a BCR::ABL1 fusion gene and in the production of an abnormal tyrosine kinase protein that causes the disordered myelopoiesis found in CML. […] Risk factors for CML include: Older age. […] Exposure to high-dose ionizing radiation.

• #42 Chronic Myelogenous Leukemia (CML): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/199425-overview

  CML is one of the few cancers known to be caused by a single, specific genetic mutation. More than 90% of cases result from a cytogenetic aberration known as the Philadelphia chromosome (see Pathophysiology). […] The initiating factor of CML is still unknown, but exposure to ionizing radiation has been implicated, as observed in the increased prevalence among survivors of the atomic bombing of Hiroshima and Nagasaki. Other agents, such as benzene, are possible causes.

• #43 About Chronic Myeloid Leukaemia (CML) | Cancer Council NSW

  https://www.cancercouncil.com.au/chronic-myeloid-leukaemia/about-chronic-myeloid-leukaemia-cml/

  Chronic myeloid leukaemia (CML) is a blood cancer that develops when the body makes too many abnormal white blood cells (known as granulocytes). […] What causes CML? Chronic leukaemia is caused by changes to one or more of the genes that control the growth and development of blood cells. These changes happen over time, but it is not known why they occur in some people and not others. Exposure to some chemicals or high doses of radiation has been linked to developing leukaemia, but this doesn’t explain most cases. […] Most people with CML have a genetic abnormality known as the Philadelphia chromosome. This abnormality is not inherited – it happens during your lifetime and is present only in the abnormal blood cells.

• #44 Chronic Myeloid Leukemia (CML): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21845-chronic-myelogenous-leukemia-cml

  Chronic myeloid leukemia (CML) is blood cancer that starts in the blood-forming myeloid cells or stem cells in your bone marrow. […] People with CML have an acquired genetic mutation or change in myeloid stem cells growing in their bone marrow. Acquired mutations aren’t present at birth and aren’t something you can inherit. Acquired mutations happen during your lifetime. […] In genetic mutations, mutated or changed genes give cells new instructions on what to do. In this case, the mutation creates a new fused gene, BCR-ABL. The new gene triggers the following chain of events that lead to chronic myeloid leukemia: The BCR-ABL gene gives new instructions to myeloid stem cells. […] The only risk factor for CML is exposure to high levels of radiation and this applies to very few people. […] No, it can’t. Medical researchers know CML happens when a specific gene mutates, but they haven’t discovered why that mutation happens.

• #45 Chronic Myelogenous Leukemia

  https://mydoctor.kaiserpermanente.org/mas/structured-content/Condition_Chronic_Myelogenous_Leukemia_-_Oncology.xml?co=/regions/mas

  Chronic myelogenous leukemia (CML) is a type of blood cancer that involves cells in the bone marrow. In CML, a cancer-causing gene (BCR-ABL) causes myeloid cells to make an abnormal enzyme. The enzyme triggers white blood cells to grow out of control. These abnormal immature white cells are leukemia cells. […] Because we know what causes CML, we have drugs to effectively treat this type of leukemia. […] The genetic mutation associated with CML isn’t passed down in families. This means you can’t pass it on to your children.

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