Wrester Roman Reigns, 39, Makes Triumphant Return To The Ring, The Superstar Leukemia Survivor Offers Hope for Young Cancer Patients

From Wrestling Champion, to Championing for Cancer Patients

• WWE superstar Roman Reigns, aka Joe Anoai, has lived with chronic myeloid leukemia (CML) since he was 22 years old. He’s currently in remission and takes regular medication as a maintenance therapy.
• Chronic Myeloid Leukemia (CML) is a type of cancer of the white blood cells.
• In CML, blast cells (immature white blood cells) form and uncontrollably multiply and divide, impairing the body’s ability to make normal, healthy blood cells.
• Although CML usually grows slowly, it can also become a faster-growing acute leukemia.
• CML is not strongly associated with environmental factors or family history. Often, patients are diagnosed after a routine blood test suggests something may be wrong and are referred to a specialist.
• Targeted therapies can specifically target CML cells while sparing healthy body cells. Tyrosine Kinase Inhibitors (TKIs) are targeted therapies that block the abnormal protein made by the CML cells, eventually killing them.

WWE superstar Roman Reigns, whose real name is Joe Anoai, has become a champion not just in the wrestling ring but also for leukemia awareness. The 39-year-old has lived with chronic myeloid leukemia, a type of blood cancer, since 2007. Anoai went public with his diagnosis in 2018 before stepping away from professional wrestling to battle the disease when he experienced a relapse. Chronic Myeloid Leukemia (CML), also known as chronic myelogenous leukemia, is a type of cancer of the white blood cells. As the disease progresses, CML cells crowd out healthy cells and eventually build up and spill over into the blood. Although CML usually grows slowly, it can also turn into a faster-growing acute leukemia, which is more challenging to treat. Now, Anoai is wrestling with a limited schedule that best coincides with his diagnosis and his family life. The wrestling superstar, a father to five children, has amassed a great deal of buzz in recent weeks despite not appearing on television since April as World Wrestling Entertainment’s (WWE) biggest television storyline teases his imminent return to the delight of millions of wrestling fans. Outside the ring, Anoai takes time to help children battling cancer by lifting their spirits as they undergo treatment.

Anoai says although his leukemia is in remission, he’s still taking medication. “For leukemia, if you caught it in an early stage like I did, you're able to take a medication, a very important medication, that I am still on to this day,” Anoai said in the A&E documentary “Biography: WWE Legends.” “It’s pretty much just a conditioning of getting your body used to these toxic medications and just hoping for the best,” Anoai added.

Expert Resources on Chronic Myeloid Leukemia

• Chronic Myeloid Leukemia (CML) is a Type of Myeloproliferative Neoplasm (MPN) What Are These?
• Digital Guide: Tyrosine Kinase Inhibitors (TKIs) for CML
• How Do I Pay for CML Treatment? Navigating the Cost of Care
• How is CML Diagnosed Without Obvious Symptoms?
• What Do Doctors Look For As Patients Undergo Oral Treatment (TKIs) For CML?
• What is the Philadelphia Chromosome in Chronic Myeloid Leukemia (CML)?

Understanding Roman’s Diagnosis

“What happens with CML is there is a cross of your chromosomes, so there is a cross between chromosome 9 and chromosome 22,” Dr. Eric Winer , clinical director of adult leukemia at Dana-Farber Cancer Institute, tells SurvivorNet. Crossing chromosomes leads to the creation of a gene called BRC-ABL, which eventually causes the overproduction of cells seen in CML. Patients diagnosed early tend to have better outcomes. "It's important for patients diagnosed with CML to understand that their prognosis is quite favorable," Dr. Jay Yang , hematologist, medical oncologist, and leader of the Hematology-Oncology Multidisciplinary Team at the Barbara Ann Karmanos Cancer Institute in Detroit, tells SurvivorNet. "With modern treatments, most patients will go on to live healthy and productive lives with a normal life expectancy." RELATED: Understanding the Key Differences Between Acute and Chronic Myeloid Leukemias WATCH: Diagnosing CML Symptoms for CML are often vague, as many other ailments can cause them. However, common symptoms include:

• Weakness
• Fatigue
• Night sweats
• Weight loss
• Fever
• Bone pain
• An enlarged spleen (which may be felt as a mass under the left side of the ribcage)
• Pain or a sense of fullness in the stomach
• Feeling full after a small amount of food

WATCH: Clinical Trials Using CAR-T Cells Are Extremely Promising. The treatment path that you and your doctor take may depend on several factors, including your age, overall health, and whether the cancer has spread or metastasized to other parts of the body. However, common treatment options to fight leukemia include:

• Chemotherapy
• Targeted therapy
• Radiation therapy
• Bone marrow or stem cell transplant
• Engineering immune cells to fight leukemia with CAR-T cell therapy, in which the body's germ-fighting T cells are reengineered to fight the cancer and infused back into your body. CAR-T might be an option for children and young adults.

Targeted Treatment for CML

A particular treatment has proven effective for chronic myeloid leukemia. Tyrosine Kinase Inhibitors (TKIs) are a targeted therapy targeting CML cells while sparing healthy cells. It works by blocking abnormal proteins made by the CML cells, eventually killing them. WATCH: Tyrosine Kinase Inhibitor Therapy Dr. Eric Winer , Clinal Director for Adult Leukemia at the Dana-Farber Cancer Institute, explains to SurvivorNet how TKI treatment works in a way many video gamers can relate to. "To oversimplify, imagine the videogame Pac-Man. These energy packets [Adenosine triphosphates (ATPs). These are energy stores within cells] that go into the mouth of the Pac-Man [BCR-ABL1 tyrosine kinase], causing it to change its conformation and shape [This] forces the CML cells to multiply. All of the TKIs block the entrance of the energy packet into the mouth of the Pac-Man, [so it] cannot change its confirmation," Dr. Winer explains. There are several TKIs on the market. Those approved as the first line of defense against CML include:

• Imatinib (brand name: Gleevec)
• Dasatinib (brand name: Sprycel)
• Nilotinib (brand name: Tasigna)
• Bosutinib (brand name: Bosulif)
• Ponatinib (brand name: Iclusig)