How is CML Treated?
Treatment for CML can keep the illness from advancing and let you move forward so you can live your life the way you are used to.
To get the most out of your treatment, it is helpful to ask questions. This will help you to:
- Understand how taking your medicine exactly as your doctor prescribed can affect your treatment and help you to get the best results possible
- Keep taking your medication and do not change the dose on your own without talking with your doctor
- Tell your doctor if you have any side effects during therapy. If so, there are many ways your doctor can help you manage side effects so you can stick with treatment
- Know what tests are used to monitor treatment response
The phases of CML
CML has 3 phases:
- The chronic phase (when symptoms are not severe and, with treatment, a person's WBC count can be nearly normal or normal)
- The accelerated phase (when WBC and platelet counts may be abnormal and the person may feel ill)
- The blast crisis phase (when WBC and platelet counts become very abnormal; bleeding, infections, and other problems can happen)
Most people find out that they have CML in the early, chronic phase. Advances in treatment are helping many more people remain in the chronic phase without moving to the more advanced phases of CML.
Types of treatment
Today, doctors have more ways than ever to treat CML. Finding out what phase of CML you are in helps you and your doctor to plan the most appropriate treatment.
These are the most common ways to treat CML:
Stem cell transplantation
Stem cell transplantation involves two steps:
- Killing most of the cells in the bone marrow (cancer cells and healthy cells) with a very high dose of one or more drugs
- Replacing the destroyed cells with only healthy cells that are taken from another person who does not have CML. The healthy cells settle into the bone marrow, where they start to grow and make normal blood cells.
For this treatment to be successful, the donor’s cells taken must match the recipient’s cells very closely. Unfortunately, finding a matched donor is often difficult. The procedure can be risky, but it may be the right choice for some people. Stem cell transplantation has been shown to cure CML in some patients.
Stem cell transplantation is also called a bone marrow transplantation (BMT).
Tyrosine kinase inhibitor
Types of drugs called tyrosine kinase inhibitors have become the most common treatment for Ph+ CML. They are different from other drugs used to treat Ph+ CML because they are designed to target the underlying cause of Ph+ CML, the Bcr-Abl protein. A tyrosine kinase inhibitor blocks this protein from telling the body to make more WBCs. This may help to prevent the abnormal growth and reduce the number of abnormal WBCs. Tyrosine kinase inhibitors have not been shown to cure Ph+ CML.
Interferon-alpha
Interferons are natural substances made by the body. They are also referred to as biologics. Injections of interferon-alpha may help slow down the growth of leukemia cells and help some people to live longer, but they have not been shown to cure CML. Interferon-alpha can often make many people feel very sick (flu-like symptoms).
Hydroxyurea
Hydroxyurea is a chemotherapy drug. Chemotherapy drugs act by killing all fast-growing cells including both abnormal and normal cells. Hydroxyurea can be given to treat some of the symptoms of CML. It is generally given at diagnosis to lower WBC count, particularly when WBC at diagnosis is very high. It has not been shown to cure CML or help people to live longer.
