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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
Find out how we produce our information|
Chemotherapy| is the use of anti-cancer (cytotoxic) drugs, which work by destroying or damaging the leukaemia cells.
The drugs circulate in the blood and can reach leukaemia cells all over the body. Our information on chemotherapy| discusses the treatment and its side effects in more detail. Information about individual drugs| and their particular side effects is also available.
Although imatinib| is the standard treatment for CML, chemotherapy is occasionally used. It‘s most likely to be used if imatinib and closely-related drugs such as dasatinib aren’t effective or cause unacceptable side effects.
Some people are given chemotherapy, usually with a tablet, when their CML is first diagnosed. This may happen when doctors are waiting for the results of tests to confirm the CML is of a type that is likely to respond to imatinib. In this situation treatment is usually changed to imatinib once the test results are available.
Often chemotherapy involves taking a tablet and this causes only mild side effects. But, sometimes more intensive chemotherapy, involving a combination of drugs given into a vein, is needed. And this causes more troublesome side effects.
People who are treated with a stem cell transplant usually have intensive chemotherapy as preparation for the transplant.
When chemotherapy is used to treat CML in chronic phase it’s usually given as tablets. The most commonly used tablet is hydroxycarbamide. These are often taken every day for as long as they are working. The dose of the tablets is changed depending on the results of regular blood tests.
Treatment may be interrupted for a time if the number of white blood cells falls below a certain level. For most people the side effects from the tablets are mild. The drug most commonly used is hydroxycarbamide|.
If CML starts to behave more like an acute leukaemia, more intensive chemotherapy is the main treatment. It generally consists of a combination of three or four drugs given by injection into a vein (intravenously).
To make giving the chemotherapy easier and so that you can avoid having frequent injections, a plastic tube (called a central line) may be put into a vein in your chest. Alternatively a PICC line (peripherally inserted central venous catheter) or implantable port may be used.
The central line| is put in under a general or local anaesthetic.
A small cut is made in the skin over your chest, and a thin flexible plastic tube is placed under your skin and into a large vein in your chest. The other end of the tube stays outside your body and has a screw cap at the end. The tube can be used to give drugs and fluids and collect blood samples.
It can stay in for months and the nurses will show you how to look after it to prevent blockages or infections.
A central line
A PICC line| is a long, fine tube put into a vein in the crook of your arm and threaded up into a larger vein leading to your heart.
An implantable port| (also known as a portocath) is a thin, soft plastic tube that is put into a large vein in the chest. It has an opening (port) just under the skin on your chest or arm.
The number and degree of side effects you have will depend on the dose you’re given and on whether you have just one type of chemotherapy tablet or a combination of drugs.
Side effects are generally more severe if higher doses are used or when several chemotherapy drugs are given together.
The main side effects may include:
Although they may be hard to bear at the time, these side effects will disappear once your treatment is over.
It’s important to take effective contraceptive precautions when you’re having chemotherapy, as the chemotherapy drugs might harm the baby if you or your partner becomes pregnant.
Unfortunately, some chemotherapy treatments may cause infertility|. Infertility is the inability to become pregnant or to father a child. This may be temporary or permanent, depending on the drugs that you have.
If you think that you may want to have children in the future, talk to your doctors about this before starting chemotherapy treatment. They will be able to tell you if your fertility is likely to be affected. You can then make an informed decision about your options.
If you have a partner it’s a good idea for both of you to be there during these discussions. Don’t be afraid to ask your doctor or specialist nurse any questions.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.