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Chemotherapy treatment

Read about chemotherapy for chronic myeloid leukaemia (CML) and the possible side effects.

Biological therapy is usually the first treatment for chronic or accelerated CML. But you might have chemotherapy instead if you can't have biological therapy for some reason. Or your treatment with biological therapy has stopped working.

You might also have chemotherapy if your CML is in the blast phase. You have chemotherapy as part of your preparation for a stem cell or bone marrow transplant.

Types of chemotherapy

The most common chemotherapy drug used for CML is hydroxycarbamide. Or you might have a drug called busulfan (Myleran, Busilvex) although this is more unusual. You are more likely to have these drugs in the chronic or accelerated phase. You have them as capsules.

The drugs used for the blast phase of CML are the same as for acute myeloid leukamia. You usually have a combination of chemotherapy drugs into your bloodstream.

High dose chemotherapy

Your doctor might suggest high dose chemotherapy treatment followed by a bone marrow or stem cell transplant if your CML doesn't respond well to imatinib (Glivec). Or if imatinib stops working. A transplant can cure some people with CML.

You need to:

  • be reasonably fit to have a bone marrow or stem cell transplant
  • go into hospital to have high dose chemotherapy through a drip

This treatment is intensive. You have a high risk of picking up an infection afterwards and will need to stay in hospital for a few weeks at least.

Taking your tablets or capsules

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

Into your bloodstream

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take newspapers, books or electronic devices to help to pass the time.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you take any supplements or if you have been prescribed anything by alternative or complementary therapy practitioners.

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. They could be harmful.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • a lower resistance to infections
  • bleeding and bruising easily
  • diarrhoea or constipation
  • hair loss
Contact your doctor or nurse immediately if you have any signs of infection such as a temperature higher than 38C or generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

  • which drugs you have
  • how much of each drug you have
  • how you react

Tell your treatment team about any side effects that you have.

 The team caring for you can help reduce your side effects.

When you go home

Chemotherapy for chronic myeloid leukaemia (CML) can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.

Information and help

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