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Treatments and drugs
By Mayo Clinic staffThe goal of chronic myelogenous leukemia treatment is to eliminate the blood cells that contain the abnormal BCR-ABL gene that causes the overabundance of diseased blood cells. For most people, it's not possible to eliminate all diseased cells, but treatment can help achieve a long-term remission of the disease.
Targeted drugs
Targeted drugs are designed to attack cancer by focusing on a specific aspect of cancer cells that allows them to grow and multiply. In chronic myelogenous leukemia, the target of these drugs is the protein produced by the BCR-ABL gene — tyrosine kinase. Targeted drugs that block the action of tyrosine kinase include:
- Imatinib (Gleevec)
- Dasatinib (Sprycel)
- Nilotinib (Tasigna)
Targeted drugs are the initial treatment for most people diagnosed with chronic myelogenous leukemia. If the disease doesn't respond or becomes resistant to the first targeted drug, doctors may consider other targeted drugs or other treatments. Side effects of these targeted drugs include swelling or puffiness of the skin, nausea, muscle cramps, rash, fatigue, diarrhea, and skin rashes.
Doctors haven't determined a safe point at which people with chronic myelogenous leukemia can stop taking targeted drugs. For this reason, most people continue to take targeted drugs even when blood tests reveal a remission of chronic myelogenous leukemia.
Blood stem cell transplant
A blood stem cell transplant, also called a bone marrow transplant, offers the only chance for a definitive cure for chronic myelogenous leukemia. However, it's usually reserved for people who haven't been helped by other treatments because blood stem cell transplants have risks and carry a high rate of serious complications.
During a blood stem cell transplant, high doses of chemotherapy drugs are used to kill the blood-forming cells in your bone marrow. Then blood stem cells from a donor or your own cells that were previously collected and stored are infused into your bloodstream. The new cells form new, healthy blood cells to replace the diseased cells.
Chemotherapy
Chemotherapy drugs are typically combined with other treatments for chronic myelogenous leukemia. Often, chemotherapy treatment for chronic myelogenous leukemia is given as a tablet you take by mouth. Side effects of chemotherapy drugs depend on what drugs you take.
Biological therapy
Biological therapies harness your body's immune system to help fight cancer. The biological drug interferon is a synthetic version of an immune system cell. Interferon may help reduce the growth of leukemia cells. Interferon may be an option if other treatments don't work or if you can't take other drugs, such as during pregnancy. Side effects of interferon include fatigue, fever, flu-like symptoms and weight loss.
Clinical trials
Clinical trials study the latest treatment for diseases or new ways of using existing treatments. Enrolling in a clinical trial for chronic myelogenous leukemia may give you the chance to try the latest treatment, but it can't guarantee a cure. Talk to your doctor about what clinical trials are available to you. Together you can discuss the benefits and risks of a clinical trial.
- Chronic myelogenous leukemia. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/PDF/cml.pdf. Accessed Sept. 15, 2010.
- Chronic myelogenous leukemia treatment (PDQ). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/CML/patient/allpages. Accessed Sept. 15, 2010.
- Liesveld JL, et al. Chronic myelogenous leukemia and related disorders. In: Lichtman MA, et al. Williams Hematology. 8th ed. New York, N.Y.: McGraw-Hill Companies, Inc.; 2010. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=69. Accessed Sept. 15, 2010.
- Kantarjian H, et al. Chronic myeloid leukemia. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008:2279.
- Integrative medicine and complementary and alternative therapies as part of blood cancer care. The Leukemia & Lymphoma Society. http://www.leukemia-lymphoma.org/attachments/National/br_1150734030.pdf. Accessed Sept. 15, 2010.
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