Chronic Myeloid Leukaemia
Chronic myeloid leukaemia (CML) is a myeloproliferative blood cancer caused by the BCR::ABL1 fusion gene, usually found in a chronic phase.
Key points
- Diagnosis requires demonstration of BCR::ABL1 rather than an elevated white-cell count alone.
- Tyrosine kinase inhibitors can produce durable control, but adherence and scheduled molecular testing are essential.
- Medicine choice balances potency and resistance profile against cardiovascular, lung, liver and interaction risks.
The listings below are not interchangeable CML options; haematology should select and monitor treatment.
Confirming phase and response
Blood and bone-marrow assessment establishes counts and disease phase, while cytogenetic or molecular testing identifies BCR::ABL1. Quantitative PCR is repeated at defined milestones; failure to fall as expected prompts checks of adherence, interactions and resistance mutations.
Targeted treatment decisions
Several BCR::ABL1 inhibitors are available with different adverse-effect profiles. Food requirements and acid-suppressing or enzyme-inducing medicines can alter exposure. Some patients with a deep sustained molecular response may attempt supervised treatment-free remission, but stopping without close testing risks unnoticed relapse.
When to seek urgent care
Contact the treating team urgently for fever, unusual bleeding, severe breathlessness, chest pain, sudden neurological symptoms, painful rapid abdominal swelling or marked weakness.



