Chronic Myeloid Leukemia - Treatment

Treatment

If CML is detected it is important to get treatment as quickly as possible.

The health professional usually knows what is best for the patient. Sometimes various combinations of treatment may be tried for the best effect. Treatment for CML depends on a number of factors such as -

• Age
• Health
• Number of affected cells in the bone marrow and peripheral blood
• Extent to which the cancer has spread to other parts of the body

The method of treatment for CML includes:

• Medications:Common medications include kinase inhibitors, interferon alpha and other cancer -curing drugs, like hydroxyurea
• Radiation: X-ray or gamma-radiations are used to kill cancer cells, to control the bone pain common to CML patients and also before a transplantation
• Bone marrow / Stem cell transplantation: Bone marrow or stem cells may be infused into the blood intravenously where they begin to make healthy cells.

1.Chronic phase

• The Chronic phase of CML is treated with tyrosinase kinase inhibitors targeted at the fusion protein synthesised by the bcr-abl gene of the ph chromosome.The first of these inhibitors was Imatinib mesylate ( marketed as Gleevec or Glivec ). This drug was approved by the FDA in 2001 and is better tolerated and more effective than previous therapies.
• Dasatinib (marketed as Sprycel), is another new drug which inhibits a wider spectrum of tyrosine kinases.This drug was approved by the FDA in June 2006 to be used for CML patients who are no longer able to respond or tolerate treatment involving imatinib.
• Bone marrow transplantation was initialy used as a mode of treatment for younger patients with CML before the advent of imatinib. Although it is known to be curative, BM transplantation is associated with a high rate of mortality.

2.Blast crisis

In the 'blast crisis' phase all the charecteristic symptoms of CML manifests themselves.This stage is also charecterized by a very high mortality rate. High dose chemotherapy is effectively used as treatment modes at this stage of CML.


In young patients in the accelerated phase, a bone marrow transplant may be considered.The chances of relapse after a bone marrow transplant is elevated in patients in the blast crisis phase or in the accelerated phase as when compared to patients in the chronic phase.

Treatment Risks

• Treatment may cause unpleasant side effects such as

1. Nausea
2. Vomitting
3. Feeling of tiredness
4. Diarrhea
5. Extra body fluid
6. Reacting badly to a transplant

Reference:

1. SUMMARY OF SPECIFIC SITES OF CANCER - (http://www.canceratlasindia.org/chapter6.asp)

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