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Chronic Myeloid Leukemia (CML) Treatment

The diagnosed phase of your chronic myeloid leukemia (CML) and presence of the Philadelphia chromosome, or Bcr-Abl oncogene, will determine your treatment plan.

Penn Medicine's Abramson Cancer Center's hematologists and medical oncologists are part of large multidisciplinary teams whose approach to cancer and blood disorders is to treat the entire individual — not just the disease.

A hematologist is a physician who specializes in blood diseases and disorders in blood-forming organs. Penn hematologists diagnose and treat patients with blood disorders such as hemophilia, leukemia, platelet disorders and anemia.

A medical oncologist is a physician who specializes in the diagnosis and treatment of cancer. Penn oncologists work closely with radiation and surgical oncologists to treat cancer patients with medical therapies such as chemotherapy, hormone therapy, immunotherapy and bone marrow and stem cell transplants.

Treatment for Chronic Myeloid Leukemia (CML) – Chronic Phase

In the Chronic phase, CML may be controlled with drugs. If you become resistant to drugs, your disease may progress to the next phase, the Accelerated Phase.

Through research and clinical trials, people with CML can now live longer, symptom-free lives.

Speak with your hematologist-oncologist about your options for treatment, and current clinical trials available for people with CML.

Treatment for Chronic Myeloid Leukemia (CML) – Accelerated Phase

In the Accelerated Phase of CML, you may be given drugs to help you get into remission, with no evidence of leukemia, or back into the chronic phase.

Also, if you have very high blood counts, your doctor may recommend removal of white blood cells through a process called leukapheresis.

Treatment for Chronic Myeloid Leukemia (CML) – Blast Phase

The Blast Phase of CML is diagnosed when you have an increase of blast cells in your bone marrow and blood. In this phase, you are at higher risk for other complications of CML such as shortness of breath, infection and bleeding.

Treatment for this phase of CML includes those listed above. Your doctor may also speak with you about a stem cell transplant.

Below are treatment options for Chronic Myeloid Leukemia (CML):

Bone Marrow and Stem Cell Transplant

Your doctor may speak with you about bone marrow and stem cell transplants. Bone marrow and stem cell transplants can help people with CML stay in remission.

There are three kinds of bone marrow and stem cell transplantation.

An autologous transplant collects your own bone marrow or stem cells before the cancer treatment. After treatment, the collected cells are returned to you to replace the cells destroyed by the cancer treatment.

An allogeneic transplant uses donor bone marrow or stem cells to replace the cells destroyed by the cancer treatment. A series of special tests are performed to find a donor who is a match for you.

Cord blood transplant removes stem cells from a baby's umbilical cord immediately after being born. The stem cells are stored until they are needed for a transplant. Umbilical cord blood cells are immature and there is less of a concern for them being a match.

Your doctor may speak with you about a transplant if you aren't responding to other treatments, you're at high risk for relapse or the anticipated benefits outweigh the risks.

About Our Bone Marrow and Stem Cell Program

Our bone marrow and stem cell transplant team are the same clinicians responsible for your overall treatment and care.

Other ways our bone marrow and stem cell transplant program are unique:

  • Our program is backed by a premier bone marrow and stem cell transplant research program that continues to make history in the development of new treatments through basic science research and clinical trials.
  • We have nationally recognized experts available to provide information, care and support throughout the transplant process.
  • Our bone marrow and stem cell transplant program is one of the oldest and largest in the country, and has pioneered new therapies to treat blood cancers.
  • We have one of the few hematologic malignancy (leukemia, lymphoma and myeloma) research programs in the country that is approved and funded by the National Cancer Institute.
  • We have a dedicated hospital unit that is completely equipped to support transplant patients. We have experienced nurses who understand the medical and personal issues patients face during transplant.
  • We serve as medical advisors for area outreach organizations, such as the Multiple Myeloma Networking Group and the Leukemia and Lymphoma Society.

Learn more about bone marrow and stem cell transplants at the Abramson Cancer Center.

Chemotherapy

The most common form of treatment for people with leukemia is chemotherapy.

Chemotherapy uses drugs to attack cancer cells, slowing or stopping their ability to grow and multiply.

Chemotherapy is usually given:

  • Orally: taking pills or capsules by mouth
  • Intravenously (IV): injecting medication into a vein
  • Intramuscularly (IM): injecting medication into a muscle
  • Subcutaneously: injecting medication under the skin

Chemotherapy is not a "one-size-fits-all" cancer treatment.

The wide range of cancer-fighting drugs attack different types of cancer cells at varying stages of cell development.

Penn medical oncologists are experts at determining which drug or combination of drugs will be the most effective in treating the various types of cancer.

For a comprehensive list of most commonly used chemotherapy agents, please visit OncoLink.

Clinical Trials for Chronic Myeloid Leukemia

Your doctor may speak with you about bone marrow and stem cell transplants. Bone marrow and stem cell transplants can help people with CML stay in remission.

There are three kinds of bone marrow and stem cell transplantation.

An autologous transplant collects your own bone marrow or stem cells before the cancer treatment. After treatment, the collected cells are returned to you to replace the cells destroyed by the cancer treatment.

An allogeneic transplant uses donor bone marrow or stem cells to replace the cells destroyed by the cancer treatment. A series of special tests are performed to find a donor who is a match for you.

Cord blood transplant removes stem cells from a baby's umbilical cord immediately after being born. The stem cells are stored until they are needed for a transplant. Umbilical cord blood cells are immature and there is less of a concern for them being a match.

Your doctor may speak with you about a transplant if you aren't responding to other treatments, you're at high risk for relapse or the anticipated benefits outweigh the risks.

Immunotherapy

Immunotherapy is designed to repair, stimulate, or enhance the immune system's responses.

Your immune system helps prevent disease, but it can also play a role in preventing cancer from developing or spreading.

The goal of immunotherapy is to enhance the body's natural defenses and its ability to fight cancer.

Immunotherapy often has fewer side effects than conventional cancer treatments because it uses your own immune system to:

  • Target specific cancer cells, thereby potentially avoiding damage to normal cells
  • Make cancer cells easier for the immune system to recognize and destroy
  • Prevent or slow tumor growth and spread of cancer cells

Read more about immunotherapy.

Integrative Oncology Services

Our integrative oncology services can supplement traditional cancer treatments such as chemotherapy.

While conventional medicine plays a critical role in eradicating cancer, integrative oncology services offer you and your family ways to minimize or reduce the side effects of cancer and cancer treatment, and promote healing and recovery.

We are knowledgeable of and support complementary cancer treatments. Our cancer teams work with patients and families to integrate these supportive programs into the overall care plan, while ensuring the safety and health of patients.

Our integrative supportive services include:

Learn more about our integrative oncology services.

Targeted Molecular Therapy

Targeted molecular therapy at Penn Medicine is a type of personalized medical therapy designed to treat cancer by interrupting unique molecular abnormalities that drive cancer growth.

Targeted therapies are drugs that are designed to interfere with a specific biochemical pathway that is central to the development, growth and spread of that particular cancer.

Because not every cancer develops in the same way in every person, targeted molecular therapy is personalized to you and your type of cancer.

In some cancers the molecular targets are known. But in other cancers these targets are still being identified. In some cases, the same types of cancer have different molecular targets.

Identifying the molecular targets in any given patient's cancer requires working closely with pathologists to carefully analyze the cancer pathology.

Targeted cancer therapies such as targeted molecular therapy give medical oncologists a better way to customize cancer treatment. Advantages of molecularly targeted therapy include:

  • Potentially less harm to normal cells
  • Potentially fewer side effects
  • Improved effectiveness
  • Improved quality of life

Read more about targeted molecular therapy.