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What to Expect From CML Treatment: An Overview

Many good CML treatments can help control your disease so you can lead a normal life. To find the best treatment for you, you'll work closely with a specialist called a hematologist-oncologist, a doctor with special training in blood diseases such as cancer.

The goal in treating CML is to destroy cells that contain the BCR-ABL gene, which leads to too many abnormal white blood cells.

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Targeted Drugs: The First Step

Your CML treatment will probably start with a type of drug called a tyrosine kinase inhibitor (TKI). TKIs block tyrosine kinase, the protein made by the BCR-ABL gene that leads to too many abnormal blood cells. Your doctor will likely prescribe a TKI such as bosutinib (Bosulif), dasatinib (Sprycel), imatinib (Gleevec), nilotinib (Tasigna), or ponatinib (Iclusig).

Most people respond to these drugs quickly. Your doctor should know within 3 to 6 months if your treatment is working.

If your CML progresses after being treated with two or more other TKIs, your doctor may switch you to omacetaxine mepesuccinate (Synribo). It helps stop the growth of cancerous cells. It’s given by injection under the skin. 

You may go into remission while you're taking a TKI. That means that the abnormal gene is no longer in your cells. It doesn't mean that you're cured -- just that your CML is under control. 

Always tell your doctor about any side effects or new symptoms.

TKI side effects include:

  • Nausea and vomiting
  • Diarrhea
  • Rash
  • Headache
  • Fatigue
  • Lower blood cell counts

Is Treatment Working?

Among the treatment goals your doctors will seek:

  • Normal blood cell counts with no abnormal white blood cells -- called a complete hematologic response.
  • No blood or bone marrow cells containing the Philadelphia chromosome, which creates the BCR-ABL gene. This is called a complete cytogenetic response.
  • No sign of BCR-ABL in your blood -- also called a complete molecular response.

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