Treatment for chronic myeloid leukaemia (CML)

The aim of treatment is to put chronic myeloid leukaemia (CML) into remission and to maintain the remission. The main treatment for CML is tyrosine kinase inhibitors (TKIs).

About treatment for chronic myeloid leukaemia (CML)

The aim of treatment is to put chronic myeloid leukaemia (CML) into remission and to maintain the remission. Remission means there are no signs of leukaemia cells in your blood or bone marrow, and you feel well. There are different levels of remission.

Remission can usually be maintained for many years – people with CML usually live a normal life-span.

We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:

Call the Macmillan Support Line on 0808 808 00 00.
Chat to our specialists online.
Visit our chronic myeloid leukaemia (CML) forum to talk with people who have been affected by chronic myeloid leukaemia (CML), share your experience, and ask an expert your questions.

Types of treatment for chronic myeloid leukaemia (CML)

Tyrosine kinase inhibitors (TKIs)

Most people with CML are treated with targeted therapy tablets called tyrosine kinase inhibitors (TKIs). These block the action of the tyrosine kinase made by the leukaemia cells. You take the tablets every day. There are many different TKIs for CML. If a TKI does not work, or stops working, you can usually be switched to a different one.

Chemotherapy

If you have a very high level of white blood cells in your blood when you are first diagnosed, you may be given chemotherapy tablets for a few days. This is usually only until the doctors check that a TKI will work for you.

Occasionally chemotherapy is used if CML is in the blast phase. A combination of 3 or 4 drugs are given into a vein (intravenously)

Stem cell transplant

If TKI treatment does not work, or if you are diagnosed in the blast phase, your doctors may suggest chemotherapy and a stem cell transplant (sometimes called a bone marrow transplant). A stem cell transplant is an intensive treatment and it is not suitable for everyone. Doctors take into account someone’s general health and fitness when they decide if it might be suitable. If you have a stem cell transplant for CML you will usually have stem cells from someone else who is a match for you (a donor). This is called a donor (or allogeneic) stem cell transplant.

Interferon alpha

If other treatments have not worked, occasionally some people are given interferon alpha in the chronic phase. Interferon alpha is an immunotherapy drug. Doctors may also use it for women who need treatment and are pregnant or want to become pregnant.

You may be invited to take part in a clinical trial of a new treatment for CML.

Reducing a high level of white blood cells in the blood

Some people have a very high number of white blood cells in their blood when they are diagnosed with CML. The cells can clog up blood vessels and cause problems. Doctors can remove the extra cells from the blood using a process is called leukapheresis.

Fertility and chronic myeloid leukaemia (CML) treatment

Some cancer treatments can affect fertility or harm a developing baby. Because of this you may be advised to use contraception to prevent a pregnancy. If you want to have children or think you may in the future, talk to your doctor about this as soon as possible. They can talk to you about the possible options for planning your treatment.

We have more information about fertility for men and fertility for women.

About our information

References

References

Below is a sample of the sources used in our chronic myeloid leukaemia (CML). If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

European Leukemia Net. Recommendations for the management of chronic myeloid leukemia. 2013.

Hoffbrand V, and Moss P. Hoffbrand’s essential haematology. 7th edition. 2016.

National Institute for Health and Care Excellence. Leukaemia (chronic myeloid) – dastatinib, nilotinib and standard dose imatinib for the first-line treatment of chronic myeloid leukaemia (part review of technology appraisal guidance 70). April 2012.

National Institute for Health and Care Excellence. Technology appraisal guidance. 401/426/425.

DeVita V, Lawrence T and Rosenberg S. 2016. Lymphomas and leukemias. From Cancer: principles and practice of oncology.

Reviewers

Reviewers

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.