Treatment options for chronic myeloid leukemia often include targeted therapies. Treatment plans and their effectiveness may depend on the phase of the condition.
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Chronic myeloid leukemia (CML) is a slow-growing type of blood cancer that can affect white and red blood cells and platelets. It occurs in about
CML has
The different phases can have an impact on a person’s overall prognosis and how a doctor and the person approach the treatment plan.
This article discusses common treatments for CML and the differences between the phases of the condition.
The chronic phase is the earliest stage of CML.
In this phase, the cancer grows and spreads most slowly, and people typically experience few or no symptoms.
Moreover, during this stage of CML, people have less than
Most people receive a diagnosis of CML in the chronic phase.
Treatment options
During the chronic phase, the first line of treatment is tyrosine kinase inhibitors (TKIs). A doctor
- nilotinib (Tasigna)
- imatinib (Gleevec)
- bosutinib (Bosulif)
- dasatinib (Sprycel)
If a specific TKI is ineffective, a doctor may change a person’s dose or use a different medication. On rare occasions, a doctor may recommend a bone marrow transplant.
Results and success from treatment
During treatment, a doctor will need to check the progress regularly. To do this, they will need to draw blood and check for levels of BCR-ABL, a cancer-causing gene, every
A
The
Options if first treatment does not work
If the first treatment does not prove effective, a doctor may consider the
- using interferon therapy or chemotherapy
- switching to a different TKI
- increasing the dose of the current drug
- performing a stem cell transplant, also known as bone marrow transplant
Treatment after stem cell transplant
Treatment following a stem cell transplant can vary based on the response a person’s body has to the transplant.
If the person’s body does not reject the transplant, a doctor
The second phase of CML is the accelerated phase, during which blast counts are higher, and symptoms are likely to develop.
In addition, during this stage, a person has increased cancer activity.
According to the
- very low platelet counts
- new chromosome changes in leukemia cells with the Philadelphia chromosome
- blood samples containing 15–30% blasts
- combined blasts and promyelocytes making up at least 30% of the blood
- blood containing 20% or more basophils
A person with accelerated phase CML is also more likely to experience symptoms such as:
- weight loss
- poor appetite
- fever
Treatment options
The
Treatment options, which will depend on what doctors have already used, may include:
- starting a TKI
- increasing the dose or switching the type of TKI
- using interferons
- combining TKI with chemotherapy
- carrying out a stem cell transplant
Results and success from treatment
It is difficult to determine the life expectancy of a person who receives a diagnosis of CML in the accelerated phase.
The
However, researchers are studying new therapies, which may help prolong the life expectancy of people with a diagnosis of accelerated CML.
The blast phase is the most advanced stage of CML.
People with a blast phase CML diagnosis have at least
Additionally, a person will likely experience fever, small appetite, and weight loss.
Treatment options
Treatment will vary between people depending on the cancer and the type of treatment a person has already undergone.
A cure for CML in the blast phase is unlikely. That is why doctors will possibly recommend medication and therapy to help a person feel better and relieve their symptoms.
According to the
If treatment is successful, a doctor may recommend a stem cell transplant.
Results and success from treatment
With newer therapies, the exact survival rate of people with a blast phase CML diagnosis is not clear.
People with blast phase CML are
A
As a result, doctors will likely recommend a different strategy,
- a new TKI
- ponatinib, which is the only TKI studies have shown works with the T315I mutation
- chemotherapy
CML is a type of cancer. There are several potential therapies a doctor may recommend a person undergo to treat the cancer, slow its growth, or improve a person’s quality of life.
Below, we describe some of the most common approaches.
Targeted therapies
Targeted therapies are medications that identify and attack cancer cells based on certain markers.
CML
According to the
Interferon therapy
Interferon therapy is the
It recreates interferons, a substance the immune system produces naturally. The therapy helps prevent the growth and division of cancer cells.
Chemotherapy
It may cure the cancer, reduce the likelihood of it returning, or slow or stop its growth. It may also improve symptoms.
Chemotherapy
Doctors will typically only recommend chemotherapy if a person does not respond well to TKIs or is undergoing a stem cell transplant.
Radiation therapy
Radiation therapy uses high doses of waves of energy to destroy cancer cells. The damaged cancer cells can no longer reproduce, and die as a result.
The
However, according to the
Doctors may use it to reduce the size of the spleen if the cancer has spread there, to treat bone pain resulting from bone damage. They may also use it during stem cell transplant throughout the body.
Surgery
Surgery is not a typical treatment option for CML. That is because the cancer can spread throughout a person’s bone marrow and other organs.
Doctors will
Stem cell transplant
A stem cell transplant involves destroying cancer cells and some healthy cells in the bone marrow, where the leukemia starts.
Once the cancer is destroyed, a doctor replaces the cells with healthy bone marrow cells that a donor provided. Usually, doctors offer this treatment option to younger people who have a matched tissue donor.
While this is the only treatment that can cure CML, it has several associated risks, including infection and graft-versus-host disease.
A person with a diagnosed CML may wish to try alternative or complementary therapies to help alleviate symptoms. They should seek guidance from a doctor to find the most suitable therapies.
According to a
However, a person should speak with their doctor about this type of treatment before finding a licensed practitioner of traditional Chinese medicine.
Another study looked at several different herbs and fruits for the treatment of leukemia. Although the study indicates more research is necessary, it reports positive results when using herbs such as ginger, garlic, and carrots.
CML is a slow-growing type of leukemia that develops in the bone marrow.
Experts distinguish three phases of the condition: chronic, accelerated, and blast. Treatments across the three phases are often similar and involve using TKIs.
A person can work with their doctor to create the best treatment options for them. If the treatment is ineffective, a doctor may recommend other therapies to achieve remission or improve a person’s quality of life.