Chronic Myeloid Leukemia (CML): Treatment Choices

There are many treatment choices for chronic myeloid leukemia (CML). Which one may work best for you? It depends on a number of factors. These include: 

  • The phase of your CML

  • Results of your tests (the number of blast cells in your blood or bone marrow)

  • Your age and overall health

  • What side effects you’ll find acceptable

Learning about your treatment options

You may have questions and concerns about your treatment options. You may also want to know how you’ll feel and function after treatment, and if you’ll have to change your normal activities.

Your healthcare provider is the best person to answer your questions. They can tell you what your treatment choices are, how well they’re expected to work, and what the risks and side effects are. A certain treatment might be advised. Or more than one treatment option may be offered, and you'll need to decide which one you’d like to use. It can be hard to make this decision. It's important to take the time you need to make the best decision for you.

Types of treatment for CML 

  • Targeted therapy. These are medicines that focus on abnormal proteins on the leukemia (cancer) cells, such as those caused by the Philadelphia chromosome. Targeted therapy works best in treating early stages of CML. They're often the first treatment used. They block an abnormal protein found in CML cells. Targeted therapy can work for a long time. But it doesn’t cure CML.

  • Stem cell transplant. This treatment is sometimes used for CML. But it's mostly used in younger people because it offers the best chance for a cure. It might be an option if other treatments, such as targeted therapy, are no longer working. Before the transplant, you get high doses of chemotherapy. And sometimes you'll get radiation therapy, too. This is done to destroy almost all your bone marrow. Then stem cells from a healthy donor are used to replace your bone marrow.

  • Immunotherapy. This treatment uses medicines to help your immune system fight leukemia. Interferon is the most common type of immunotherapy used to treat CML. It’s not used very often because other, newer treatments work better.

  • Chemotherapy (chemo). This treatment uses strong medicines to kill cancer cells. It's not a common treatment for CML. Its goal is to kill the cancer cells and put the cancer into remission. Remission means there are no signs of cancer in the body. The most common chemo medicine used for CML is hydroxyurea. It can control the number of leukemia cells, but it can’t cure the disease. 

  • Radiation therapy. This treatment uses strong X-rays to kill cancer cells. It can be used to kill leukemia cells that have spread to an organ, such as your spleen. It’s not a common treatment for CML.

  • Surgery. A splenectomy is surgery to take out your spleen. Your spleen may be removed to improve your blood cell counts or to reduce pressure on other organs caused by a swollen spleen. Still, this surgery is not often used for CML.

Clinical trials for new treatments 

Researchers are always finding new ways to treat CML. These new methods are tested in clinical trials. Talk with your healthcare provider to find out if there are any clinical trials you should think about.

Talking with your healthcare providers

At first, thinking about treatment options may seem overwhelming. Talk with your healthcare team and loved ones. Make a list of questions. Look at the benefits and possible side effects of each option. Discuss your concerns with your healthcare providers before making a decision.

Online Medical Reviewer: Kimberly Stump-Sutliff RN MSN AOCNS
Online Medical Reviewer: Louise Cunningham RN BSN
Online Medical Reviewer: Todd Gersten MD
Date Last Reviewed: 2/1/2021
© 2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare provider's instructions.