Chronic Myelogenous Leukemia (CML) is a form of cancer of blood and bone marrow that attacks white blood cells. It grows gradually and is thought to be a long term type of leukemia.
What It Is?
CML develops as a genetic defect that forms an abnormal chromosome known as the Philadelphia chromosome (Ph chromosome).
This chromosome carries an abnormal gene BCR-ABL that produces a protein (tyrosine kinase) that promotes unregulated proliferation of white blood cells.
Phases of CML
CML unchecked normally develops in 3 stages:
Chronic Phase (the most frequent at diagnosis)
Few or no symptoms.
Anomalous blood tests of white blood cells.
The patients are responsive to treatment.
Accelerated Phase
There is a faster increase in white blood cells.
Such symptoms as fever, night sweats, fatigue, and weight loss can be observed.
Blast Crisis
Leukemia acts as acute leukemia does.
Big masses of undeveloped cells (blasts) are found in blood and bone marrow.
More difficult to treat.
Chronic Myelogenous Leukemia treatment in India
First-Line Treatment (Chronic Phase – the majority of patients at diagnosis):
Treatment of choice is targeted therapy with Tyrosine Kinase Inhibitors (TKIs)
These medications inhibit the abnormal BCR-ABL protein, halting out-of-control cell growth.
Taken every day in oral tablet form.
Monitoring:
Serial blood tests (CBC).
Molecular studies (PCR for BCR-ABL level).
Objective: deep molecular response (undetectable BCR-ABL).
If Resistance or Intolerance to First-Line TKI:
Switch to a different TKI (e.g., if patient fails imatinib, use dasatinib, nilotinib, bosutinib, or ponatinib).
Mutation testing (to screen for T315I or other mutations that direct drug selection).
Advanced Disease (Accelerated Phase or Blast Crisis):
TKIs (usually higher dose or next-generation TKIs).
Chemotherapy combination in blast crisis (because it acts like acute leukemia).
Allogeneic Stem Cell Transplant:
Reserved if CML advances despite TKIs.
Only curative option, but significant risks (infection, graft-versus-host disease).
Supportive & Additional Therapies:
Hydroxyurea → occasionally used to rapidly decrease high white blood cells prior to initiating TKI.
Interferon-alpha → now infrequently used (pre-TKIs, was first-line treatment; now used during pregnancy when TKIs are unsafe).
Bone marrow/stem cell transplant → reserved for resistant disease or younger adults.
Treatment Goals:
Chronic phase: Maintain patient as stable, not allow progression.
Long-term: Induce deep molecular remission (close to or below detectable level of BCR-ABL).
Some patients: Can try for treatment-free remission (discontinuing TKIs) after prolonged periods of undetectable disease, on close follow-up.
Best hospitals for Chronic Myelogenous Leukemia in India
Artemis Hospital, Gurgaon
Medanta-The Medicity, Gurgaon
Fortis Memorial Research Institute, Gurgaon
Max Hospital, Saket
Top doctors for Chronic Myelogenous Leukemia in India
Dr. Gaurav Dixit
Dr. Mukesh Patekar
Dr. Lalit Kumar
Dr. Ashok Kumar Vaid
Dr. Nitin Sood
Dr. Vinod Raina
Dr. Ankur Bahl
Dr. Rahul Bhargava
Dr. Rayaz Ahmed
Factors Affecting Cost of Chronic Myelogenous Leukemia treatment in India
Factors determining the cost of treating Chronic Myelogenous Leukemia (CML) in India, based on authentic sources and contextual understandings:
Key Cost Drivers for CML Treatment in India:
Nature of Treatment Needed
Targeted Therapy (TKIs)
Chemotherapy
Stem Cell Transplant (SCT/BMT)
Monitoring and Diagnostic Costs
Monitoring Tests:
Regular cytogenetics
FISH
PCR for BCR-ABL
Initial Diagnostic Workups:
May include blood work, bone marrow biopsy, imaging, and genetic testing— costlier.
Institutional and Geographic Differences
Hospital Site and Reputation:
Large metro cities like Delhi, Mumbai, Bangalore, Hyderabad, Chennai usually charge more
Government hospitals or smaller- to mid-sized cities might have cheaper alternatives
Hospital Stay & Amenities:
Room rents per day, ICU rates, fees for doctors, and supportive care all contribute to higher expense.
Physician Expertise
Oncologists with much experience may cost more, affecting procedure or consultation fees
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Why Choose GetWellGo for Chronic Myelogenous Leukemia Treatment?
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