What Happens Next?
Now that you’ve been diagnosed with CML, you may not know what to do next. To make sure you're getting the most expert care, you should see a hematologic oncologist, a doctor who specializes in treating CML. If you don’t already have a specialist, ask your primary care doctor for a referral or check with a cancer organization such as the Leukemia & Lymphoma society.
The first step is to learn as much as possible about your condition. CML will seem a lot less scary and a lot more manageable once you understand it better. Ask your treatment team for brochures or other printed materials. Or look for information on reputable web sites like the American Cancer Society or the Leukemia & Lymphoma Society.
Don't be afraid to ask questions. You need to understand your condition and how it will be treated, so that you can make important decisions about your own care and treatment.
Write down a list of questions to bring with you to your doctor’s appointments. Ask questions about your condition and treatment plan, such as:
- What are my treatment options?
- Which treatment is best for me?
- What kinds of results can I expect from CML treatment?
- What side effects might I experience from CML treatment?
- Do I need a second opinion?
Your goal is to stay in the chronic CML phase for as long as possible and remain symptom-free. You can help your doctors achieve that goal by:
- Keeping all of your medical appointments
- Following the treatment plan your doctor prescribed
- Keeping your doctor updated on any treatment-related side effects you’re experiencing
- Telling your doctor if any new symptoms develop
- Asking questions about your treatment plan if you are unclear about any aspects
The goal of CML treatment is to destroy the abnormal blood cells in your body, and return the number of healthy blood cells to normal.
Typically, CML treatment starts with drugs known as tyrosine kinase inhibitors (TKI), which work to block the action of tyrosine kinase.
- The most common and oldest drug for initial therapy is imatinib (Gleevec).
- The drugs dasatinib (Sprycel) and nilotinib (Tasigna) are FDA-approved for the initial treatment of CML.
- Bosutinib (Bosulif) and ponatinib (Iclusig) are other TKIs and can be used if a person is resistant to or cannot tolerate the side effects of other drugs.
- Yet another drug, Synribo (omacetaxine mepesuccinate), is approved for those whose disease has progressed after using two or more TKIs.
Other CML treatment options include a stem cell transplant, chemotherapy, such as hydroxyurea or busulfan, or biologic therapy with interferon.
Stem cell transplantation is an option when other therapies have failed. Stem cell transplantation for CML requires a matching donor.