Chronic myeloid leukemia, also known as chronic myelogenous leukemia or CML, is a kind of leukemia that starts in the cells in the bone marrow that form blood, according to the American Cancer Society. CML cells accumulate in the body over time, so people do not usually have symptoms for several years. There are various kinds of treatments available for CML, depending on the extent of disease, prognosis, and the patient's age and general health.
Targeted Therapies
Targeted therapies are medications that target specific proteins and characteristics of cancer cells and have become standard in treating CML, according to the American Cancer Society. CML cancer cells have a protein, BCR-ABL that is made by the oncogene bcr-abl, that healthy cells do not have. Targeted therapies look for this protein and target these cells, which are the cancerous cells. Drugs in this category include imatinib (brand name Gleevec), nilotinib (Tasigna) and dasatanib (Sprycel). These are all taken orally as a pill. Common side effects of these medications can include fatigue, nausea, diarrhea, muscle pain and itchy rashes.
Interferon Therapy
Interferons are made by our immune systems, and interferon-alpha is the kind most often used to treat CML. Interferon-alpha helps stop and slow the growth and replication of leukemia cells and is given as a subcutaneous daily injection. Side effects of interferon can be severe, including bone pain, muscle aches, fever, fatigue, nausea and vomiting and other flu-like symptoms.
Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells and is typically given intravenously or orally, as a pill. This enables the medicine to spread throughout the bloodstream and kill cancer cells throughout the entire body. While chemotherapy used to be the main treatment for CML, targeted therapies have largely replaced it, although it is still used when targeted therapies stop working, as well as before a stem cell transplant. Commonly used chemotherapy drugs to treat CML include hydroxyurea (Hydrea), cytarabine (Ara-C), busulfan, cyclophosphamide and vincristine. Side effects can include mouth sores, hair loss, loss of appetite, fatigue, nausea and vomiting, and altered white and red blood cell and platelet counts.
Bone Marrow or Peripheral Stem Cell Transplant
In a bone marrow or peripheral stem cell transplant, full-body radiation or high-dose chemotherapy is administered to kill leukemic cells, and then stem cells that were taken from the blood or bone marrow are given to the patient. These stem cells help the body restore its blood cells, according to the National Cancer Institute.
