Chronic Myelogenous Leukemia: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Chronic Myelogenous Leukemia?
A hematologist (a doctor who treats blood diseases) or an oncologist (a cancer doctor) usually treats chronic myelogenous leukemia. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is chronic myelogenous leukemia?
Chronic myelogenous leukemia, or CML, is a cancer that starts inside the bone marrow. Bone marrow is the soft tissue in the center of bones that helps form all blood cells. CML causes uncontrolled growth of immature and mature cells. These cells make a certain type of white blood cell called myeloid cells.
CML is a slowly progressing blood and bone marrow disease. It usually occurs during or after middle age, and it rarely occurs in children. Doctors group CML into three phases. They are chronic, accelerated, and blast crisis.
Symptoms
The chronic phase can last for months or years. The disease may have few or no symptoms during this time. Most people are diagnosed during this stage, when blood tests are done for other reasons. Possible symptoms of CML include:
- Fatigue, which means feeling very tired
- Weight loss for no known reason
- Drenching night sweats
- Fever
- Pain or a feeling of fullness below the ribs on the left side
Sometimes CML does not cause any symptoms at all. The accelerated phase is more dangerous. Leukemia cells grow more quickly. Common symptoms in this phase include fever (even without infection), bone pain, and a swollen spleen. Untreated CML leads to the blast crisis phase. Bleeding and infection may occur due to bone marrow failure.
Causes and who gets it
CML is usually linked to an abnormal chromosome called the Philadelphia chromosome. In CML, part of the DNA from one chromosome moves to another chromosome. This makes the bone marrow produce a protein called tyrosine kinase. The protein causes too many stem cells to become white blood cells. The Philadelphia chromosome is not passed from parent to child.
Radiation exposure can increase the risk of developing CML. This can come from past radiation treatments for thyroid cancer or Hodgkin lymphoma, or from a nuclear disaster. Most people with CML have not been exposed to radiation.
How doctors diagnose it
A physical exam often reveals a swollen spleen. A complete blood count, or CBC, shows an increased number of white blood cells, many of them immature. A bone marrow biopsy uses a needle in the hipbone or breastbone. It removes bone marrow, blood, and a small piece of bone. Blood and bone marrow are also tested for the Philadelphia chromosome.
Treatment
You and your cancer care team will decide on a treatment plan together. It may include more than one type of treatment. Medicines that target the abnormal protein made by the Philadelphia chromosome are often the first treatment. One kind is called a tyrosine kinase inhibitor. It blocks an enzyme that makes the body create more white blood cells than it needs. These medicines are almost always taken as pills. People treated with these medicines often go into remission quickly and can stay in remission for many years. In some people with a deep remission, the medicine may be stopped without the leukemia returning. Decisions about whether to continue, change, or stop treatment may be based on follow-up test results. Never stop your medicine on your own. Only your cancer doctor can decide if stopping is safe.
Sometimes chemotherapy is used first to reduce the white blood cell count if it is very high at diagnosis. Chemotherapy can have serious side effects, depending on the medicines used. A stem cell or bone marrow transplant is often considered if the disease comes back or gets worse while taking the medicines. The blast crisis phase is very difficult to treat. Medicines such as tyrosine kinase inhibitors have greatly improved the outlook for people with CML.
When to see a doctor
Check with your doctor if you have the symptoms listed above. These signs can be caused by CML or by other conditions. Call 911 or go to the emergency room if you have trouble breathing, chest pain, fainting, a sudden change in mental state, or bleeding that will not stop.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can review your symptoms and can order a complete blood count (CBC), a blood test that counts your blood cells. Follow-up tests or check-ups may be needed as you go through treatment.
Common questions
Is chronic myelogenous leukemia the same as chronic myeloid leukemia?
Yes, they are two names for the same disease.
Is the Philadelphia chromosome passed from parent to child?
No, the Philadelphia chromosome is not passed from parent to child. In CML, part of the DNA from one chromosome moves to another chromosome.
Does chronic myelogenous leukemia always cause symptoms?
No, sometimes CML does not cause any symptoms at all.
Can people with chronic myelogenous leukemia stay in remission?
Yes, many people can stay in remission for many years while taking their medicine.
Sources
- MedlinePlus - Chronic myelogenous leukemia (CML)
- National Cancer Institute - Chronic Myeloid Leukemia Treatment (PDQ), Patient Version
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
