Prevention

The causes of CML are not fully understood, and there is no evidence that CML can be prevented.

Risk factors

• gender (males are at a slightly higher risk)
• exposure to high-dose radiation (e.g. nuclear disaster), but this is rare in Australia.

Early detection

GPs should be aware of the possibility of CML in patients with leucocytosis or thrombocytosis, or those with non-specific symptoms of fatigue, weight loss, sweats and malaise. Early satiety and abdominal discomfort may be related to progressive splenomegaly.

Most cases of mild leucocytosis with neutrophilia will be due to other causes, but a PCR test for BCR-ABL1 to screen for CML should be ordered if either:

• the white blood cell (WBC) count is over 25
• leucocytosis or thrombocytosis is confirmed on a repeat blood test
• there are features on the blood film that raise the possibility of CML.

Screening recommendations

Screening is not indicated for CML.

General health checklist

• Recent weight changes discussed and the patient’s weight recorded
• Alcohol intake and smoking status discussed and support offered if appropriate
• Physical activity recorded
• Referral to a dietitian considered