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Doctors classify chronic myelogenous leukemia (CML) into the following three stages of the disease:

• Chronic phase
• Accelerated phase
• Blastic phase

Chronic Phase

• Approximately 80% of patients with chronic myelogenous leukemia are diagnosed in the chronic phase of the disease.

• About half of the patients in the chronic phase are asymptomatic and have no clinical symptoms of the disease.

• Patients in the chronic phase who develop symptoms most commonly present with anemia, splenomegaly, fever, weight loss, and generalized fatigue.

• The most common laboratory finding in the chronic phase is leukocytosis - an abnormally elevated white blood cell count.

• This phase can be usually be controlled with medications.

• The chronic phase of chronic myelogenous leukemia may last anywhere from several months to about 4 to 5 years.

Accelerated Phase

Nearly 80% of patients with chronic myelogenous leukemia will progress from the chronic phase of the disease to the accelerated phase. The accelerated phase of the disease is a more advanced phase than the chronic phase.

Features of the accelerated phase of chronic myelogenous leukemia include:

• An elevation in the number of "blasts" in the peripheral blood or bone marrow. Approximately 10% to 15% of cells are "blasts" (immature, leukemic white blood cells).
• Clinical signs and symptoms of chronic myelogenous leukemia may become more evident.
• Enlargement of the spleen (splenomegaly) becomes more pronounced.
• Leukocytosis - abnormally elevated levels of white blood cells in the blood.
• Thrombocytosis - abnormally high number of platelets in the blood.
• Thrombocytopenia an abnormal decrease of platelets in the circulating blood.
• The median duration of survival for patients who are diagnosed in the accelerated phase is 1 to 2 years.

Blastic Phase and Blast Crisis

The blastic phase is the most advanced phase of chronic myelogenous leukemia. It is characterized by the presence of 30% or more "blast" cells in the bone marrow or peripheral blood. When clinical signs and symptoms of chronic myelogenous leukemia occur during the blast phase this is called "blast crisis". In addition to the signs and symptoms mentioned previously, bone pain, infections, and bleeding can occur during blast crisis. Eccymoses, a purplish patch caused by the seepage of blood into the skin, may also be a primary feature of blast crisis. Blast crisis is similar to acute leukemia and survival is about 3 to 6 months at this stage.