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Even if you've been living with Philadelphia chromosome–positive chronic myeloid leukemia (Ph+ CML) in chronic phase for a while, it's still helpful to understand the biology behind the disease and what's happening in your body.

A swap between chromosomes 9 and 22 creates the Ph chromosome

What causes Ph+ CML? 

Ph+ CML is caused by an abnormal fusion gene called BCR‑ABL1. It is the result of pieces of 2 chromosomes in the body trading places.

Here’s a brief overview:

• Each cell in the human body has 23 pairs of chromosomes

• In Ph+ CML, pieces from chromosomes 9 and 22 break off and swap places

• This can create a new abnormal chromosome known as the Philadelphia (Ph) chromosome

• The Ph chromosome creates the abnormal BCR-ABL1 fusion gene

• This abnormal gene then produces an abnormal protein called BCR-ABL

How does Ph+ CML affect the body?   Ph+ CML affects your bone marrow and your blood. Your bone marrow is a sponge-like tissue in the center of most of your bones.

Here’s what happens in the bone marrow:

• The BCR-ABL protein sends too many signals to the bone marrow

• The bone marrow starts creating too many immature white blood cells (commonly referred to as blast cells)

• These cells, which your doctor may call leukemic cells, grow abnormally and do not become healthy white blood cells

• The leukemic cells start to grow and divide and build up, crowding out red blood cells and platelets in the bone marrow

Here’s what happens in the bloodstream:

• As the bone marrow becomes overcrowded with leukemic cells, these cells move into the bloodstream

• Over time, the leukemic cells crowd out healthy red blood cells, white blood cells, and platelets

• This can lead to serious health problems, including, but not limited to, a greater risk of infections, as well as anemia, bruising easily, and bleeding that takes longer to stop 

Doctors categorize Ph+ CML in phases instead of stages

While many types of cancer are categorized into stages, doctors assign 1 of 3 phases to Ph+ CML:

• Chronic phase: The first phase of Ph+ CML, when the number of white blood cells is higher than normal. Most adults are diagnosed in chronic phase

• Accelerated phase: The second phase of Ph+ CML, in which the number of immature white blood cells in the blood and bone marrow may increase rapidly

• Blast phase: The third and final phase of Ph+ CML. This phase has the highest number of immature blood cells in the blood and bone marrow

Take an active role in learning about Ph+ CML   The more you know about your disease, the better you may be able to communicate with your doctor. Go to the Helpful Resources page to find contact information for a wide range of advocacy groups that support patients with Ph+ CML. You’ll also learn about one of the many apps that you can use to track your treatment and connect with patients.   Helpful Resources

Learn about SCEMBLIX as a treatment option

By being your own advocate, you can work closely with your doctor to determine whether SCEMBLIX is right for you.
SCEMBLIX is a prescription medicine used to treat adults with:

• Philadelphia chromosome–positive chronic myeloid leukemia (Ph+ CML) in chronic phase (CP), previously treated with 2 or more tyrosine kinase inhibitors (TKIs). Learn More

• Ph+ CML in CP with the T315I mutation. Learn More

It is not known if SCEMBLIX is safe and effective in children.

Next: Understanding the T315I Mutation in Ph+ CML in Chronic Phase >