Treatment for chronic myeloid leukaemia (CML)
Main treatments for chronic myeloid leukaemia (CML)
The following are used in the treatment of CML:
- High-dose therapy with stem cell transplant.
- Biological therapies.
Chemotherapy is the use of anti-cancer drugs to cure or control the leukaemia. It might be given together with a biological therapy. One drug given in tablet form is hydroxycarbamide.
Please see our Understanding Chemotherapy and Other Cancer Drugs, which you can download from our "Publications about cancer treatment side effects" list on the right hand side of this page, booklet for more details. For more information about specific drugs, see the chemotherapy drug information page.
The main treatment for CML is biological therapies. These therapies work by using your body´s immune system to treat leukaemia. There are different types of biological therapies. For example, monoclonal antibodies and immunotherapy.
The most common drugs used are:
- imatinib (Gilvec)
- Nilotinib (Tasigna®) is a new drug that is only available here in Ireland as part of a clinical trail. It can be given instead of Glivec or if you can no longer tolerate Glivec. For more information about specific drugs, see the biological drugs therapies section.
High-dose treatment with stem cell support
If your CML does not respond well to Glivec or becomes resistant to it, your doctor might suggest another treatment. This could involve high-dose chemotherapy with a stem cell transplant. The treatment might be given if you are in a blast crisis. A blast crisis is a sudden growth of leukaemia cells with a lot of blast cells in your bone marrow and blood.
The aim of the treatment is to give high doses of chemotherapy to destroy all the blood cells in your bone marrow and replace them with stem cells. These stem cells can then grow into new healthy blood cells.
Before the high dose chemotherapy is given, the stem cells are taken from your bone marrow or your bloodstream (peripheral blood). If the cells are taken from you, it is known as an autologous transplant. If they are taken from someone else, it is known as an allogeneic transplant.
This treatment can help to improve the chances of curing the leukaemia or help to make a remission last longer. Remission is when there are no active signs of the disease. Your doctor will discuss this treatment with you if he or she thinks it is needed or suitable for you.
For more information please see our booklets and factsheets:
- Understanding Stem Cell Collection
- Understanding Autologous Stem Cell Transplants
- Total Body Irradiation
The type of side-effects you get will depend on the type of treatment, the dose, the duration and your own general health. Some treatments may cause symptoms such as vomiting, itchy rash, joint pains, fever, chills and headaches. You might feel sick (nausea) and you might lose your appetite. Some treatments cause hair loss and most make you feel very tired (fatigue). The high-dose treatments and stem cell transplant may cause low immunity or a lowered resistance to infection.
Your doctors will also watch you carefully both during the transplant and for a number of months afterwards. They will check for any signs of the new marrow reacting against your own body tissue. This is known as graft versus host disease.
Most side-effects do not last long and disappear once treatment is over. Your doctor or nurse will discuss any possible side-effects with you before your treatment begins.
For more about coping with side-effects, see the booklets Understanding Chemotherapy and Other Cancer Drugs, Understanding Radiotherapy, Coping with Fatigue, Diet and Cancer and Understanding Cancer and Complementary Therapies, all available to download under the "Publications about cancer treatment side effects" list on the right hand side of this page.
If a treatment looks like it might be helpful, it is often given to patients in research studies called clinical trials. Trials may be taking place at the hospital you are attending. If you are interested in taking part, talk to your doctor. He or she can advise you if the trial would suit you or not.