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Chemotherapy treatment

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells.

Targeted cancer drugs such as imatinib are usually the first treatment for chronic or accelerated CML. But you might have chemotherapy instead if you can't have a targeted drug for some reason. 

Or you might have chemotherapy at first to reduce your white blood cell count or to control symptoms while you are waiting for test results to confirm your diagnosis.

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. This aims to reduce your white blood cell count and control any symptoms you might be having. You take hydroxycarbamide as capsules.

The drugs used for the blast phase of CML are the same as for acute myeloid leukaemia (AML). You usually have a combination of chemotherapy drugs into your bloodstream through a drip.

High dose chemotherapy

Your doctor might suggest high dose chemotherapy treatment followed by a stem cell or bone marrow transplant if your CML has not responded to previous treatment with targeted cancer drugs such as imatinib. 

You need to:

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

This treatment is intensive and not suitable for everyone. You have a high risk of picking up an infection afterwards and will need to stay in hospital for a few weeks at least.

How you have chemotherapy

You might take chemotherapy as capsules, or have it directly into your bloodstream (intravenously).

Taking your capsules or tablets

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.

Talk to your specialist or advice line before you stop taking a cancer drug.

Into your bloodstream

You have the treatment through a drip into your arm or hand. 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 can usually take chemotherapy capsules at home. Your doctor or pharmacist gives you instructions on when and how to take them.

You have treatment that goes into your bloodstream through a drip at the cancer day clinic or as an inpatient on the ward. It can take several hours to have chemotherapy so it’s a good idea to have something to read to help to pass the time. A friend or family member can usually be with you to keep you company.

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 37.5C 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.

When you go home

Chemotherapy for 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.

Last reviewed: 
10 May 2019
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    A. Hochhaus and others

    Annals of Oncology, 28, (Supplement 4) pages 41-51, 2017

  • Chronic myeloid leukaemia
    Professor J F. Apperley
    The lancet. Volume 385, Issue 9976, 11–17 April 2015, Pages 1447–1459

  • Essential haematology
    Hoffbrand and Moss, 7th Edition, 2016

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