Treating Chronic Myelogenous Leukemia
Different types of treatment are available for people with chronic myelogenous leukemia (CML). Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. The six types of standard treatment used to treat CML are targeted therapy, chemotherapy, biologic therapy, high-dose chemotherapy with stem cell transplant, donor lymphocyte infusion, and surgery.
♦ Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Tyrosine kinase inhibitors are targeted therapy drugs used to treat CML. Imatinib mesylate, nilotinib, and dasatinib are tyrosine kinase inhibitors that may be used as initial treatment for people newly diagnosed with chronic-phase CML.
♦ Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity (such as the abdomen), the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Targeted therapy uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
♦ Biologic therapy is a treatment that uses an individual’s immune system to fight his or her cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
♦ High-dose chemotherapy with stem cell transplant is a method of giving high doses of chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells are removed from the blood or bone marrow of the person with cancer or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the person with cancer through an infusion. These re-infused stem cells grow into (and restore) the body’s blood cells.
CML Has Three Phases
After a person has been diagnosed with chronic myelogenous leukemia, tests are done to find out if the cancer has spread. Staging is the process used to find out how far the cancer has spread. There is no standard staging system for CML. Instead, the disease is classified by phase: chronic phase, accelerated phase, or blastic phase. It is important to know the phase in order to plan treatment. The information from tests and procedures done to detect and diagnose CML is also used to plan treatment.
♦ Donor lymphocyte infusion is a cancer treatment that may be used after stem cell transplant. Lymphocytes (a type of white blood cell) from the stem cell transplant donor are removed from the donor’s blood and may be frozen for storage. The donor’s lymphocytes are thawed if they were frozen and then given to the person with cancer through one or more infusions. The lymphocytes see the individual’s cancer cells as not belonging to the body and attack them.
♦ Splenectomy is surgery to remove the spleen.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated during or after treatment. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called restaging . Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred, or come back.
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For some people, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process, and they are taking place in many parts of the country. For more information about cancer clinical trials or to search the National Cancer Institute’s list of clinical trials now accepting participants, visit cancer.gov/clinicaltrials.
Source: National Cancer Institute
This article was originally published in Coping® with Cancer magazine, May/June 2013.