Chronic Myeloid Leukemia (CML) Samples

Bay Biosciences provides high-quality, resh frozen biopsy tissue, bone marrow aspirates. In addition, matched fresh frozen sera (serum),  plasma, and peripheral blood mononuclear cells (PBMC) bio-fluids from patients diagnosed with chronic myeloid leukemia (CML).

Moreover, the sera (serum), plasma and PBMC bio-fluids are processed from chronic myeloid leukemia (CML) patient’s peripheral whole-blood using customized collection and processing protocols.

In addition, the matched bio-fluids are collected from unique patients with chronic myeloid leukemia (CML) and are provided to a valued pharmaceutical customer for research, development and drug discovery.

 

Chronic Myeloid Leukemia (CML) Overview

Leukemia is a cancer of the blood. Leukemia begins when healthy blood cells change and grow out of control. Chronic myeloid leukemia (CML) is a cancer of the blood-forming cells, called myeloid cells, found in the bone marrow. Bone marrow is the spongy, red tissue in the inner part of large bones. Chronic myeloid leukemia (CML) most often causes an increase in the number of white blood cells, such as neutrophils or granulocytes, that normally fight infection. It also sometimes goes by the names chronic granulocytic, chronic myelocytic, or chronic myelogenous leukemia.

What is Leukemia?

Leukemia is a type of cancer that starts in the blood or blood-forming tissues. There are many different types of leukemia, and treatment is different for each one. Chronic leukemias are slower growing than acute leukemias, but can be just as life-threatening. Chronic myelogenous leukemia (CML) also goes by the names chronic myeloid leukemia, chronic myelocytic leukemia, and chronic granulocytic leukemia.

This is a cancer of the white blood cells. In CML, blast cells, or immature white blood cells, form and multiply uncontrollably, they crowd out all the other types of necessary blood cells.

Genetic Mutations

Patients with chronic myeloid leukemia (CML) have a genetic mutation or change in their bone marrow cells. They call it a translocation. A translocation occurs when part of a long strand of genes called a chromosome breaks off and reattaches to another chromosome.

In chronic myeloid leukemia (CML), part of chromosome 9 breaks off and bonds to a section of chromosome 22, forming the Philadelphia chromosome or Ph chromosome. The Ph chromosome comprises 2 genes called BCR and ABL that join together into a single fusion gene called BCR-ABL.

It is found only in the blood-forming cells, not in other organs of the body. The BCR-ABL gene causes myeloid cells to make an abnormally activated enzyme.

Specifically, it is a tyrosine kinase enzyme. Researchers call this abnormally activated enzyme a fusion protein and allow white blood cells to grow out of control.

 This genetic change develops from damage that occurs by chance after a person is born. There is no risk that a person will pass on this gene to their children.

Normally the number of white blood cells is tightly controlled by the body, more white blood cells are produced during infections or times of stress, but then the numbers return to normal when the infection is cured.

In chronic myeloid leukemia (CML), the abnormal BCR-ABL enzyme is like a switch that is stuck in the “on” position, it keeps stimulating the white blood cells to grow and multiply.

In addition to increased white blood cells, the number of blood platelets that help the blood to clot often increase. And, the number of red blood cells, which carry oxygen, may decrease.

Signs and Symptoms of Chronic Myeloid Leukemia (CML)

Following are the common signs and symptoms of chronic myeloid leukemia (CML). The symptoms of chronic myeloid leukemia (CML) can also appear as symptoms of a variety of other conditions, which can make people easily ignore or dismiss them. They include:

  • First, anemia 
  • Second, abdominal swelling or discomfort due to an enlarged spleen
  • Third, bleeding 
  • Moreover, excessive sweating, especially at night
  • Furthermore, weakness
  • In addition, tiredness
  • Next, shortness of breath
  • Also, itching
  • Likewise, bone pain
  • For example, weight loss
  • Additionally, fever
  • Lastly, sense of fullness or bloating in the stomach
  • Finally, feeling full after eating, even if only a small amount

Symptoms alone will not be enough to diagnose chronic myeloid leukemia (CML) because they’re common in several types of cancers, as well as other more common conditions.

Causes of Chronic Myeloid Leukemia (CML)

Chronic myeloid leukemia (CML) is caused by a genetic mutation, it is not known what exactly causes the initial mutation, but most likely the genetic mutation that leads to chronic myeloid leukemia (CML) is not passed on by parents. In humans, there are 23 pairs of chromosomes.

In patients with chronic myeloid leukemia (CML), they switch part of chromosome 9 with a piece of chromosome 22. This creates a short chromosome 22 and a very long chromosome 9. According to Mayo Clinic, they call the short chromosome 22 the Philadelphia chromosome, and it is present in 90 percent of chronic myeloid leukemia (CML) patients. Genes from chromosomes 9 and 22 combine to form the BCR-ABL gene that enables specific blood cells to multiply uncontrollably, causing chronic myeloid leukemia (CML).

Phases of Chronic Myeloid Leukemia (CML)

Chronic myeloid leukemia (CML) doctors divide it into the following 3 different phases: chronic, accelerated, or blast.

Chronic Phase

  • First, Chronic phase: The blood and bone marrow contain less than 10% blasts. Blasts are immature white blood cells. This phase can last for several years. However, without effective treatment, the disease can progress to the accelerated or blast phases. About 90% of patients have chronic phase chronic myeloid leukemia (CML) when they are diagnosed. Some patients with chronic phase chronic myeloid leukemia (CML) have symptoms when they are diagnosed and some do not. Most symptoms go away once treatment begins.

Accelerated Phase

  • Next, Accelerated phase: There is no single definition of accelerated phase. However, most patients with this phase of chronic myeloid leukemia (CML) have 10% to 19% blasts in both the blood and bone marrow or more than 20% basophils in the peripheral blood. A basophil is a special type of white blood cell. These cells sometimes have new cytogenetic changes in addition to the Philadelphia chromosome, because of additional DNA damage and mutations in the chronic myeloid leukemia (CML) cells.

Blast Phase

  • In addition, Blast phase, also called blast crisis: In the blast phase, there are 20% or more blasts in the blood or bone marrow, and it is difficult to control the number of white blood cells. The chronic myeloid leukemia (CML) cells often have additional genetic changes as well. The blast cells can look like the immature cells seen in patients with other types of leukemia, specifically acute lymphoblastic leukemia for about 25% of patients or acute myeloid leukemia for most patients. Patients in blast phase often have a fever, an enlarged spleen, weight loss, and generally feel unwell.

Resistant CML

  • Finally, Resistant CML: Resistant CML is chronic myeloid leukemia (CML) that has come back after treatment or does not respond to treatment. If the CML does return, there will be another round of tests to learn about the extent of the disease. These tests and scans are often similar to those done at the time of the original diagnosis.

Progression

Without effective treatment, chronic myeloid leukemia (CML) in chronic phase will eventually move into accelerated phase at first and then into blast phase in about 3 to 4 years after diagnosis. Patients who have more blasts or an increased number of basophils, chromosome changes in addition to the Philadelphia chromosome, high numbers of white blood cells, or a very enlarged spleen often experience blast phase sooner.

Risk Factors of Chronic Myeloid Leukemia (CML)

The cause of chronic myeloid leukemia (CML) is not known, though researchers now understand how the disease develops from genetic changes in the bone marrow cells. Environmental factors account for only a small number of CML diagnoses. Family history does not appear to play a role in the development of chronic myeloid leukemia (CML).

The following factors may raise a person’s risk of developing chronic myeloid leukemia (CML):

  • Age. The average age of people diagnosed with chronic myeloid leukemia (CML) is around 64. chronic myeloid leukemia (CML) is uncommon in children and teens.
  • Radiation exposure. Many people who were long-term survivors of the 1945 atomic bombings in Japan were diagnosed with chronic myeloid leukemia (CML) Many long-term survivors of the 1945 atomic bombings in Japan received a diagnosis of chronic myeloid leukemia (CML). In addition, researchers have linked radiation therapy for a condition called ankylosing spondylitis to chronic myeloid leukemia (CML).
  • However, there is no proven link between chronic myeloid leukemia (CML) and radiation therapy or chemotherapy given for other types of cancer or other diseases.
  • Gender. Men are somewhat more likely to develop chronic myeloid leukemia (CML) than women.

Diagnosis of Chronic Myeloid Leukemia (CML)

Following are the common tests used to diagnose and monitor chronic myeloid leukemia (CML):

Blood Tests

  • First, Blood tests: Most patients are diagnosed with chronic myeloid leukemia (CML) through a blood test called a complete blood count (CBA) before they have any symptoms. A CBC counts the number of different kinds of cells in the blood. A CBC is often done as part of a regular medical checkup. Chronic myeloid leukemia (CML) patients have high levels of white blood cells. However, white blood cell levels might also be caused by conditions that are not leukemia. When the chronic myeloid leukemia (CML) disease is more advanced, there may also be low levels of red blood cells, a condition called anemia, and either high or low numbers of platelets.

Bone Marrow Aspiration

  • Second, Bone marrow aspiration and Biopsy: These two procedures are similar and often done at the same time to examine the bone marrow. Bone marrow has both a solid and a liquid part. A bone marrow aspiration uses a needle to remove a sample of the fluid containing bone marrow cells. A bone marrow biopsy is the removal of a small amount of solid tissue using a needle. A pathologist then analyzes the samples. A cytogenetic analysis may also be done on the bone marrow samples. A common site for a bone marrow aspiration and biopsy is the iliac crest of the pelvic bone, which is located in the lower back by the hip. A bone marrow biopsy can usually be done in the doctor’s office, without a need to stay in the hospital. Before the procedure, the skin in that area is usually numbed with medication. Other types of anesthesia may also be used.

Molecular Testsing

  • Next, Molecular testing: Your doctor may recommend testing the leukemia cells for specific genes, proteins, and other factors unique to the leukemia. Results of these tests can help determine your treatment options.
  • Cytogenetics is a type of genetic testing that is used to analyze a cell’s chromosomes. It looks at the number, size, shape, and arrangement of the chromosomes. Occasionally, doctors can perform this test on the peripheral or circulating blood when they first diagnose chronic myeloid leukemia (CML), but they need to use immature blood cells that are actively dividing. 

Cytogenic Testing

  • The following tests are used with cytogenetic testing:
      • Fluorescence in situ hybridization (FISH) detects the BCR-ABL gene and monitors the disease during treatment. This test does not require anyone to divide cells, and you can use a blood sample or bone marrow cells. Moreover, this test is a more sensitive way to find chronic myeloid leukemia (CML) than the standard cytogenetic tests that identify the Philadelphia chromosome.
      • Polymerase chain reaction (PCR) is a DNA test that can find the BCR-ABL fusion gene and other molecular abnormalities. PCR tests may also be used to monitor how well treatment is working. This test is quite sensitive and, depending on the technique used, can find 1 abnormal cell mixed in with approximately 1 million healthy cells. This test can be done using a blood sample or bone marrow cells.

Testing During Treatment

After treatment begins, doctors repeat cytogenetic and/or molecular testing on another bone marrow sample to find out if there are fewer cells with the Philadelphia chromosome.

  • Imaging tests: Doctors may use imaging tests to find out if the leukemia is affecting other parts of the body. For example, doctors use a computed tomography (CAT or CT) scan and ultrasound examination to look at and measure the size of the spleen in patients with chronic myeloid leukemia (CML).
  • A CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these images into a detailed, 3-dimensional image that shows any abnormalities. Sometimes, healthcare providers give a special dye called a contrast medium before the scan to provide better detail on the image. This dye can inject into a patient’s vein or provide as a liquid to swallow.
  •  An ultrasound uses high-frequency sound waves to create a picture of the inside of the body.

 

Biospecimens

Bay Biosciences is, indeed a global leader in providing researchers with high quality, clinical grade, fully characterized human tissue samples, bio-specimens, and human bio-fluid collections.

Specifically, aamples available include cancer (tumor) tissue, cancer serum, cancer plasma, cancer, peripheral blood mononuclear cells (PBMC) and human tissue samples from most other therapeutic areas and diseases.

Moreover, Bay Biosciences maintains and manages its own biorepository, the human tissue bank (biobank) consisting of thousands of diseased samples (specimens) and from normal healthy donors available in all formats and types.

In fact, our biobank procures and stores fully consented, de-identified and institutional review boards (IRB) approved human tissue samples and matched controls.

Additionally, all our human tissue collections, human specimens and human bio-fluids are provided with detailed, samples associated patient’s clinical data.

In particular, critical patient’s clinical data includes information relating to their past and current disease, treatment history, lifestyle choices, biomarkers, and genetic information.

Moreover, researchers find patient’s data extremely valuable and use it to help identify new effective treatments (drug discovery & development) in oncology, and other therapeutic areas and diseases.

Specifically, Bay Biosciences banks wide variety of human tissue samples and biological samples, including cryogenically preserved at – 80°C.

For example fresh frozen tissue samples, tumor tissue samples, formalin-fixed paraffin-embedded (FFPE), tissue slides, with matching human bio-fluids, whole blood and blood-derived products such as serum, plasma and PBMC.

Furthermore, Bay Biosciences is a global leader in collecting and providing human tissue samples according to the specified requirements and customized, tailor-made collection protocols.

Therefore, please contact us anytime to discuss your special research projects and customized human tissue sample requirements.

Types of Biospecimens

Bay Biosciences provides human tissue samples (human specimens) from diseased and normal healthy donors which includes:

  • Firstly, Peripheral whole-blood
  • Secondly, Amniotic fluid
  • Third, Bronchoalveolar lavage fluid (BAL)
  • Moreover, Sputum
  • Furthermore, Pleural effusion
  • Next, Cerebrospinal fluid (CSF)
  • Also, Serum (sera)
  • Likewise, Plasma
  • In addition, Peripheral blood mononuclear cells (PBMC)
  • For example, Saliva
  • Also, Buffy coat
  • Moreover, Urine
  • Furthermore, stool samples
  • Next, Aqueous humor
  • Likewise, Vitreous humor
  • Lastly, Kidney stones (renal calculi)
  • Finally, Other bodily fluids from most diseases including cancer.

Moreover, we can also procure most human bio-specimens, furthermore; we offer special collections and requests for human samples that are difficult to find. All our human tissue samples are procured through IRB-approved clinical protocols and procedures.

In addition to the standard processing protocols, Bay Biosciences can also provide human plasma, serum, and PBMC bio-fluid samples using custom processing protocols. Additionally you buy donor-specific collections in higher volumes and specified sample aliquots from us.

Furthermore, Bay Biosciences also provides human samples from normal healthy donors; volunteers, for controls and clinical research, contact us Now.

 

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