Treatment for Chronic Myelomonocytic Leukemia (CMML)

Our physicians are part of a multidisciplinary team whose approach to cancer and blood disorders is to personalize the treatment plan for each patient and to treat them holistically, focusing on the whole person and not just on their disease.

There are different types of treatments for patients with chronic myelomonocytic leukemia (CMML). In addition to standard therapies, there are novel therapies available through clinical trials. It is important to discuss any questions you have about clinical trials, or to let your doctor know if you are interested in participating in a clinical trial.

Some people with CMML do not require active treatment of their disorder for a long time, and others will.

Bone Marrow and Stem Cell Transplant

Your doctor may speak with you about bone marrow and stem cell transplants. High dose chemotherapy and bone marrow and stem cell transplants are the only known therapy with a potential for cure of advanced myelodysplastic syndromes.

In an allogeneic transplant, donor bone marrow or stem cells are used to replace the patient's diseased cells after high dose-chemotherapy. A series of special tests are performed to find a donor who is a match for you.

Your doctor may speak with you about a transplant if you are not responding to other treatments, if you are at high risk for progression, and if the anticipated benefits outweigh the risks.

Read more about donor bone marrow and stem cell transplants.

Chemotherapy / Drug Therapy

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

Chemotherapy can be 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 at Penn Medicine for Myelodysplastic/Myeloproliferative Syndromes and CMML

Clinical trials benefit patients with access to breakthrough therapies and treatments. Because of clinical trials and research, the landscape of therapy for myelodysplastic syndromes is changing at a rapid pace.

The treatments and therapies today would not be possible without clinical trials.

Because more and more treatments for blood cancers are becoming available, it is important to speak with your doctor about available clinical trials throughout your entire cancer treatment.

Cancer specialists at the Abramson Cancer Center are part of the Eastern Cooperative Oncology Group (ECOG), one of the largest clinical cancer research organizations in the nation.

With the ECOG, cancer specialists from Penn are designing clinical trials to test novel therapies, new agents, or new treatment standards for people with myelodysplastic/myeloproliferative syndromes.

Because clinical trials are updated frequently, it's important to ask your physician about clinical trials throughout your entire treatment.

Advantages of Clinical Trials

Being in a clinical trial offers you the opportunity to be treated with treatments, medications or agents that are not otherwise available.

It also gives you the opportunity to be treated by, and have your case reviewed by experts who are directly involved with the design of the treatment.

Through clinical trials:

  • Diagnosing cancer has become more precise
  • Radiation and surgical techniques have advanced
  • Medications are more successful
  • Combinations of medical, surgical and radiation therapy are improving treatment effectiveness and enhancing outcomes
  • Strategies to address the late effects of cancer and its treatment have been developed to improve the quality of life

Learn more about clinical trials, frequently asked questions about clinical trials, and available clinical trials at the Abramson Cancer Center.

Growth Factors

Growth factors are drugs used to help stimulate the bone marrow to produce blood cells.

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:

Radiation Therapy

Radiation therapy uses high-energy radiation to kill cancer cells. A radiation therapy schedule usually consists of a specific number of treatments given over an extended period of time. In many cases, radiation therapy is capable of killing all of the cancer cells.

Radiation oncologists at Penn Medicine are recognized for techniques that target radiation precisely to the disease site while sparing nearby tissue.

For people with CMML, radiation therapy is usually directed at the spleen.

Surgery

If needed, your doctor may recommend surgery to remove your spleen.

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.

Transfusions

Because people with CMML may have low red blood cell or platelet counts, a transfusion can be used to help them feel better.

Watchful Waiting

Active surveillance, or "watchful waiting" requires you to be monitored closely by your physician. This "watch and wait" approach allows you to avoid the side effects from cancer treatment, since your disease is stable and not showing symptoms.