Chronic Myeloid Leukemia (CML)

Chronic myeloid leukemia (CML) is a cancer of the blood and bone marrow that primarily affects adults. In 2025, approximately 9,560 new cases are expected to be diagnosed in the United States, with about 1,290 deaths attributed to the disease. CML accounts for about 15% of all new leukemia cases. The average age at diagnosis is around 64, and it is rarely seen in children.  

Columbia’s specialized approach to CML allows us to deliver personalized care through advanced diagnostics, targeted therapies, and access to CML clinical trials. Our team includes experts who focus specifically on CML, ensuring that your care is guided by physicians at the forefront of CML treatment and research. Our goal is to help you live a full and healthy life with the support of an expert team at every stage of your care.

What is chronic myeloid leukemia (CML)?

CML begins when two chromosomes—9 and 22—swap pieces of genetic material during cell division. This change creates a shortened chromosome known as the Philadelphia chromosome, which produces an abnormal gene called BCR-ABL. The BCR-ABL gene acts like a switch stuck in the "on" position, telling the bone marrow to produce too many immature white blood cells. 

Thanks to major advances in treatment, including targeted therapies that specifically block BCR-ABL, CML is now considered one of the most successfully managed types of leukemia. 

At Columbia, we use special tests to identify the presence of the Philadelphia chromosome and tailor your treatment plan based on your disease phase and individual health needs. 

What are CML symptoms?

Many people with CML have no symptoms when they are diagnosed, so the disease is often found during routine bloodwork. 

When symptoms are present, they may include: 

• Fatigue or weakness 
• Unexplained weight loss 
• Night sweats 
• Fever 
• A feeling of fullness below the ribs (from an enlarged spleen) 

How is CML diagnosed?

Diagnosing CML involves a combination of blood tests and specialized genetic testing. Columbia uses the latest diagnostic tools available to ensure an accurate and complete assessment: 

• Complete blood count (CBC): Detects elevated white blood cell counts and other blood abnormalities 
• Bone marrow biopsy: Assesses disease phase and marrow involvement 
• Chromosome analysis (FISH and karyotyping): Identifies the Philadelphia chromosome 
• Molecular testing (PCR testing): Measures the BCR-ABL gene to track treatment response

CML is classified into three phases—chronic, accelerated, and blast phase—based on the percentage of immature cells (blasts) in the blood and bone marrow. Most patients are diagnosed in chronic phase, and often do not have any symptoms. Your phase at diagnosis helps us guide the choice of treatment and predicts the expected course of the disease. 

What are the treatments for CML?

Most people with CML are diagnosed in the chronic phase, when the disease is easier to control. Columbia offers the full range of treatment options to help manage CML effectively and minimize side effects. 

Our approach to CML treatment includes: 

• Targeted therapies. CML is most commonly treated with oral medications known as tyrosine kinase inhibitors (TKIs), which block the activity of the BCR-ABL protein. Common TKIs include imatinib, dasatinib, nilotinib, asciminib, and ponatinib. These treatments have dramatically improved survival rates for CML. 
• Monitoring and molecular testing. Regular blood tests and PCR testing help us monitor your response to therapy and adjust treatment if needed. 
• Stem cell transplantation. In rare cases—such as advanced-phase disease or resistance to multiple TKIs—an allogeneic stem cell transplant may be considered. Columbia’s transplant specialists work closely with each patient to evaluate all available options. 
• Personalized treatment planning. Our Columbia team will provide a treatment plan made just for you, assessed and supported by a fully specialized team of hematologists, transplant experts, pathologists, and research physicians. 

Clinical trials for CML

Columbia is at the forefront of research to improve outcomes for people with CML. Our clinical trials program offers access to: 

• Next-generation TKIs and combination therapies 
• Investigational treatments for TKI-resistant or advanced-phase CML 
• Studies evaluating minimal residual disease (MRD) detection and treatment-free remission strategies 

Participating in a clinical trial may provide access to more effective therapies not yet widely available—and contributes to advancing better CML care for all patients.