Patients with chronic myeloid leukemia (CML) begin treatment with imatinib mesylate (Gleevec), which blocks the abnormal protein from the Bcr-Abl gene that’s causing the CML cells to grow uncontrolled. As a result, Gleevec stops the growth of the CML cells and causes them to die off. Your blood is then returned to normal.
Almost all people with CML get some benefit from Gleevec. This drug, taken by mouth, is not the same as chemotherapy. It has little to no effect on healthy tissues, so it has less severe side effects than chemotherapy. Still, it is not entirely side effect–free. Your doctor can give you details about how Gleevec may affect you. It does not cure CML, but it keeps CML under control for many patients for as long as they take it.
There are other drugs that are used for CML—including older drugs such hydroxyurea, cytarabine and interferon—that can help control blood counts in CML but are not as good as imatinib. Newer drugs called dasatinib and nilotinib, similar to imatinib, are also available. These drugs are currently used when imatinib no longer works.
Researchers, including physicians and scientists at Seattle Cancer Care Alliance, are investigating better use of available drugs, as well as newer drugs that show promise in treating CML. If you are interested, ask your physician if there are clinical studies available using drugs that treat your disease.
High-dose chemotherapy along with allogeneic stem cell transplantation (using cells from a donor) is the only treatment that can cure CML at this time. This treatment is most successful in younger patients, but people up to 60 years of age who have a matched donor may be considered for this treatment as well.
Allogeneic transplantation can be a high-risk procedure. Studies are under way to see whether CML patients have better long-term outcomes with drug therapy or with transplantation.