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Decisions about your treatment

Find out how your doctor decides which treatment you need for chronic myeloid leukamia (CML) and the types of treatment you might have.

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

The MDT look at a number of different factors including: 

  • the phase of your AML
  • your general health
  • your age and level of fitness

Treatment overview

The main treatments for CML are:

  • biologicial therapies
  • chemotherapy
  • radiotherapy
  • stem cell or bone marrow transplant

Treatment by phase

Chronic phase

Biological therapy is the most common treatment for this phase using a drug called imatinib (Glivec). Most people respond well to this treatment and the CML can stay under control for several years.

Imatinib might not work for some people, or it stops working after a period of time. In this situation, your doctor might recommend another type of biological therapy called nilotinib (Tasigna). 

Other treatment options include:

  • chemotherapy
  • intensive treatment with a bone marrow or stem cell transplant

A transplant is not suitable for everyone. You have to be reasonably fit and well to cope with the treatment and its side effects.

For CML, you usually have a transplant using the stem cells or bone marrow of a donor. This is called an allogeneic transplant. You might also have total body irradiation (TBI) as part of your preparation for your transplant.

Accelerated phase

The treatment for the accelerated phase depends on the treatment you have already had. Imatinib (Glivec) is normally the first choice unless you have already had it in the chronic phase.

Some people who have imatinib for the first time in the accelerated phase might have a good response to treatment. It might put their CML back into the more stable chronic phase for a time.

You might have treatment with another biological therapy if you have already had imatinib. For example, nilotinib (Tasigna) or dasatinib (Sprycel).

Other treatment options include chemotherapy. Or your doctor might recommend more intensive treatment using a bone marrow or stem cell transplant. This is more likely if you are younger and fairly fit and well. 

Blast phase

Your doctor might suggest treatment with imatinib (Glivec) if you haven’t had it before. Or you might have other biological treatments, such as nilotinib or dasatinib.

Other options include:

  • chemotherapy with a combination of drugs that is usually used for acute leukaemia
  • a bone marrow or stem cell transplant

You might have treatment to relieve symptoms. For example, radiotherapy to shrink an enlarged spleen. Or radiotherapy to reduce pain in the bones.

Clinical trials to improve treatment

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to improve treatment by:

  • making existing treatments better
  • developing new treatments

Information and help

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About Cancer generously supported by Dangoor Education since 2010.