Chronic myeloid leukemia refers to a type of cancer that begins in particular blood-forming cells found in the bone marrow. Genetic change occurs in the early version of the myeloid cells; that is the cells that are responsible for the production of the platelets, most white blood cells, and red blood cells. In this paper, the discussion is about the genetics of CML and the significance of the Philadelphia chromosome. Also how the approach goals of treatment and counseling the patient
Genetics of CML and the significance of the Philadelphia chromosome
The functioning and growth of human beings are based on information found in cell’s chromosomes. Chromosomes contained in molecules of DNA, which is the chemical that bears a person’s gene. A cell duplicates a DNA in its chromosome every time a cell plans to split into two new cells; this can cause an error which could have an effect on genes inside the DNA. Cancer might be due to mutation of the DNA, which turns on tumor suppressor ( a gene that causes death of cells at the right time or slows down cell division) or oncogenes (genes that support cell division and growth). Chronic myeloid leukemia occurs when swapping of DNA (chromosomal material) takes place between chromosomal 22 and 9 during the division of the cell. A portion of chromosomal 22 goes to 9 and fraction of chromosomal 9 goes to 22. The process is called translocation that leads to chromosome 22 being shorter than normal. As a result, the abnormal chromosome is referred to as Philadelphia chromosome. All patients with CML have Philadelphia chromosome that originates in the leukemia cells. DNA between chromosome swaps to form a new gene known as BCR-ABL, this protein cause CML cells to develop and replicate out of control. Few CML patients have BCR-ABL except Philadelphia chromosome. (Talpaz et al, 2006)
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Goals of Treatment and Counseling of CML Patient.
Goals of Chronic Myelogenous Leukemia treatment include cytogenetic remission (normal chromosome come back with Ph+ cells), molecular remission (PCR result for mutational BCR/ABL) and hematologic remission (physical examination and standard complete blood cell count). CML patients are encouraged to undergo full health assessment including laboratory tests, emotional and physical status, diagnosis and to accesses caregivers in communities, homes and resource centers. The CML patient is taught how to manage their condition to live longer. (Kurzrock et al, 2003)
References
Talpaz M, Shah NP, Kantarjian H, et al. (June 2006). "Dasatinib in imatinib-resistant Philadelphia chromosome-positive leukemias" . N. Engl. J. Med. 354 (24): 2531–41.
Kurzrock,R,;Kantarjian, H. M.; Druker, B. J.;Talpaz, M. (2003). "Philadelphia chromosome-positive leukemia: From basic mechanisms to molecular therapeutics". Annals of Internal Medicine 138 (10): 819–830.
